Turkish signature to the diagnosis of pudendal nerve compression, one of the most common causes of genital and pelvic pain.
One of the most common causes of genital and pelvic pain, “Pudendal Neuropathy”, also known as “Pudendal Nerve Jam”, is a problem in every 15 people in our country. However, due to the difficulty of the diagnosis and the fact that many physicians are not familiar with the subject, patients may have to live with difficulties for years without diagnosis. Thanks to the new diagnostic method developed by Neurology Specialist Assoc. Prof. Burcu Örmeci, the diagnosis can be made much faster and more accurately. Thus, it is possible to proceed to the treatment without wasting time.
A problem similar to wrist nerve compression, known in the community as carpal tunnel syndrome, can occur in the Pudendal nerve, which is responsible for the genital area. This problem, which manifests itself with problems such as pain especially with sitting in the genital area, sexual function problems, urination or incontinence, is often confused with urinary tract infections or prostate inflammation. Therefore, patients may have to continue living with pain, despite the antibiotic treatment they have received for months. It is very important to diagnose in time, as pudendal nerve compression can have results that can take the person from the society to the point of abstraction as well as physical problems.
PATIENTS’ QUALITY OF LIFE DETERIORATES
This problem, which occurs especially in women who have given too many births, can start suddenly due to heavy lifting, reverse movement, falling or a heavy sports activity, and may also occur gradually over time. Assoc. Prof. Burcu Örmeci, who says that the most prominent feature of the pudendal nerve compression is the pain sensation that the patient experiences while sitting, gives the following information about the problems experienced by the patient,
“Pain caused by pudendal compression is usually seen near the nerve. Patients talk about the sense of alienation in the vagina and rectum. However, they complain of pain during bowel movements, unbearable pain due to pressure from urination (especially in constipation). The pain that is felt less in the morning hours but increases during the day is described as burning, tearing, electrifying and stinging like a sharp knife. It is not accompanied by itching or loss of sensation. In such a table, it is necessary to suspect that a different problem exists. In addition, the sense of pain in the hips while sitting but not in every patient, pain that spreads to the sciatic nerve area and does not respond to treatment, frequent urination, pain during sexual intercourse especially in women, are among the supporting supportive findings”.
Patients with pudendal nerve compression cannot perform simple daily activities such as driving or cycling. In short, as the quality of life of the patients deteriorates, they have difficulty in doing the activities required by daily life.
CANNOT BE DETECTED BY IMAGING METHODS
Different methods, from laboratory findings to imaging, are used for the diagnosis of pudendal nerve compression. However, since the underlying cause is not found most of the time, the patient can be directed to receive treatment in this direction, considering that the source of the problem is psychological. Assoc. Prof. Burcu Örmeci, who says that it is very difficult to perform electrical diagnosis methods (such as EMG, SEP) as the nerve passes deep, gives the following information: “The pudendal nerve is located both on the left and the right side of the genital area, but neuropathic pain is usually seen on one side or more on one side. Since the evaluations have been carried out so far in a way to evaluate the midline, even two nerves, at the same time, the diagnosis could not be made because the problematic or less problematic nerve covers the findings of the problematic nerve. In addition, although pain appeared while sitting, examinations were being made by having the patient lied down. This was preventing the problem from being detected”.
THE DIAGNOSIS METHOD WAS ALSO ACCEPTED INTERNATIONALLY
Explaining that they have started to evaluate the two nerves separately with the electrical diagnosis method they developed, Assoc. Prof. Burcu Örmeci continues her words as follows: “We have further developed the existing method. With the small electrodes we placed on the right and left, we managed to evaluate the two nerves separately. Thus, we succeeded to determine whether there was compression in the unilateral or bilateral Pudendal nerve. We also succeeded to shoot, not while in laying position, but also in a sitting position which is considered that the pain is most severe. Thanks to this, diagnoses that could not be made for 3-4 years in the past can now be made faster. This method, which we use as a standard diagnostic method, was also accepted by international authorities”.