The role of complex neurophysiological studies in diagnosing pudendal neuropathy in patients with pelvic organ prolapse and pain syndrome


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Abstract

Objective. To assess the role of complex neurophysiological studies in detecting pudendal neuropathy in patients with painful syndrome associated with pelvic organ prolapse. Materials and methods. The study included 44 patients with pelvic organ prolapse and pelvic pain syndrome. All patients underwent a complex examination including physical examination, colonoscopy, defecography, sphincterometry and complex neurophysiological examination using stimulation electroneuromyography for the investigation of latency of motor nerve conduction (M-response latency), deep pudendal reflex (DPR) and bulbocavernous reflex (BCR). Results. According to the findings of the neurophysiological study, neuropathy in patients with pain syndrome associated with the pelvic organ prolapse occurred unilaterally or bilaterally in all cases. Neuropathy was diagnosed in 65.9% of patients on the basis of the increased M-response latency (in combination with changed parameters of BCR/DPR), and in 34.1% of cases this condition was identified only due to changed parameters of DPR and/or BCR. Conclusion. The neurophysiological studies have shown that neuropathy in patients with pain syndrome associated with the pelvic organ prolapse occurred unilaterally or bilaterally in all cases. Neuropathy was diagnosed in 65.9% of patients on the basis of the increased M-response latency (in combination with changed parameters of BCR/ DPR), and in 34.1% of cases this condition was identified only due to changed parameters of deep pudendal reflex and/or bulbocavernous reflex.

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About the authors

Oksana Yu. Fomenko

Ryzhikh National Medical Research Centre for Coloproctology, Ministry of Health of Russia

Email: info@gnck.ru
Head of the Laboratory of clinical pathophysiology, Associate Professor, MD, PhD

Sergey I. Achkasov

Ryzhikh National Medical Research Centre for Coloproctology, Ministry of Health of Russia

Email: info@gnck.ru
Head of the Department of oncology and colon surgery, Professor, MD, PhD

Vladislav I. Krasnopolsky

Moscow Regional Research Institute of Obstetrics and Gynecology

Email: gyn_endoscopy@mail.ru
Academician of the Russian Academy of Sciences, MD, PhD, Professor, President

Mikhail Yu. Martynov

Moscow Regional Research Institute of Obstetrics and Gynecology

Email: rsmu@rsmu.ru
Corresponding Member of the Russian Academy of Sciences, MD, PhD, Professor of the Department of neurology, neurosurgery and medical genetics

Gennady V. Poryadin

Pirogov Russian National Research Medical University, Ministry of Health of Russia

Email: rsmu@rsmu.ru
Corresponding Member of the Russian Academy of Sciences, MD, PhD, Honorary Head of the Department of pathophysiology and clinical pathophysiology

Aleksandr A. Popov

Moscow Regional Research Institute of Obstetrics and Gynecology

Email: gyn_endoscopy@mail.ru
MD, PhD, Professor, Head of the Department of endoscopic surgery

Jean M. Salmasi

Pirogov Russian National Research Medical University, Ministry of Health of Russia

Email: rsmu@rsmu.ru
MD, PhD, Head of the Department of pathophysiology and clinical pathophysiology

Svetlana V. Belousova

Ryzhikh National Medical Research Centre for Coloproctology, Ministry of Health of Russia

Email: info@gnck.ru
senior researcher of the Laboratory of clinical pathophysiology, MD, PhD

Denis V. Aleshin

Ryzhikh National Medical Research Centre for Coloproctology, Ministry of Health of Russia

Email: info@gnck.ru

Vladimir A. Kozlov

Ryzhikh National Medical Research Centre for Coloproctology, Ministry of Health of Russia

Email: info@gnck.ru
MD, PhD, leading researcher of the Department of endoscopic surgery

Anton A. Fedorov

Moscow Regional Research Institute of Obstetrics and Gynecology

Email: gyn_endoscopy@mail.ru
MD, PhD, leading researcher of the Department of endoscopic surgery

Maksim A. Nekrasov

Ryzhikh National Medical Research Centre for Coloproctology, Ministry of Health of Russia

Email: info@gnck.ru
MD, junior researcher of the Laboratory of clinical pathophysiology

Elena S. Efremova

Moscow Regional Research Institute of Obstetrics and Gynecology

Email: gyn_endoscopy@mail.ru
surgeon of the Department of endoscopic surgery

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