[Traction on the orthopedic table and pudendal nerve injury. Importance of electrophysiologic examination]. / Tractions sur table orthopédique et atteinte du nerf pudendal. Intérêt des explorations électrophysiologiques.

PURPOSE OF THE STUDY: We performed a retrospective study about perioperative pudendal nerve palsy following fracture table tractions. MATERIAL: Six palsies were investigated. Mean age was 26 years. All of them presented sensitive and motor dysfunctions secondary to nerve compression following tractions on the fracture table. METHODS: All of them had complete electrophysiological recordings including perineal electromyogram, measurement of sacral roots latencies, sensory velocity of the dorsal nerve of the penis, somatosensory evoked potentials of the pudendal nerve and measurement of its terminal branches. RESULTS: Neurological symptoms were stereotyped associating sensory signs and sexual disorders, must of them being transient. Perineal electrophysiological examination always confirmed reality of pudendal nerve palsy. DISCUSSION: We discuss incidence, mechanism, etiology and prevention of this pudendal nerve palsy. CONCLUSION: Emergence of stereotyped perineal symptoms following orthopaedic surgery, especially after tractions on fracture table, must prevail on physicians to search for pudendal nerve palsy. Usual outcome is good in the six months following surgery, but definitive aftermath does occur. Perineal electrophysiological examination can confirm pudendal nerve palsy and give prognosis elements.

[Treatments of perineal neuralgia caused by involvement of the pudendal nerve]. / Traitements des névralgies périnéales par atteinte du nerf pudendal. A propos de 170 cas.

We report 170 cases of perineal neuralgia due to pudendal nerve compression within Alcock canal or by ischiatic spine. 117 women and 53 men were investigated. Mean age was 60.3 years and the follow-up one year. Infiltrations of the pudendal nerve in the ischio-rectal fossa (pudendal canal or Alcock canal) with corticoids under CT-scan guidance, were successful immediately in only 1/3 of the cases. Infiltrations of the nerve near by ischiatic spine (radioscopic guidance) were successful in 57 p. 100, but only in 15 p. 100 of the cas after one year. Surgical treatment (performed in 27 cases) was good (8 or excellent (9). For all treatments, the results are good in 65 p. 100 of the cases. Perineal neurophysiologic examinations are useful to confirm pudendal nerve lesion and propose specific medical and/or surgical treatment.

[Penile neuropathy: clinical and electrophysiologic study. Report of 186 cases]. / La neuropathie pénienne: Etude clinique et électrophysiologique: A propos de 186 cas.

Penile neuropathy is a common disease due to lesion of the sensory branch of the pudendal nerve, ie, the dorsal nerve of the penis. Sexual disorders (deterioration of erection) and sensory signs (hypoesthesia or paresthesia of the penis) are noted in patients with penile neuropathy. Electrophysiological recordings help guide the diagnosis (reduction of the sensory velocity of the dorsal nerve of the penis). Many etiologies can be found (traumatic, toxic, compressive), but the most common lesion is neuropathy related to diabetes.