Comparaison entre la latence distale motrice du nerf pudendal, la topographie de la douleur périnéale et le résultat d'infiltrations. Analyse pour 53 patients Comparison between the terminal motor pudendal nerve terminal motor latency, the localization of the perineal neuralgia and the result of infiltrations. Analysis of 53 patients

AbstractAim. – The aim is to study the value of the pudendal nerve terminal motor latency (PNTML) testing, in respect to the painful side in patientswith pudenda neuralgia, and to determine whether a possible increased latency in the painful side is predictive of a good result with the infiltra-tion.Method. – This retrospective study included 53 outpatients (42 women, mean age 62) with suffering from pudendal neuralgia, who were seenbetween 2000 and 2004. The mean duration of the pain was 30 ± 47 months. The PNTMPNL was measured by the Saint-Mark hospital techni-que, by the same operator. The following criteria have been were defined: significant increased latency greater than above 6 ms, significantdifference of 2 ms in latency between 2 sides from 2 ms, and side of the infiltration corresponding to the side of the neuralgia. The infiltrationswere performed either by perineal (30 cases) or transgluteal (8 cases) way. The results on pain were have been considered as good when asubstantial reduction of the pain was observed for 6 months or more. Statistical analysis involved was done by the exact Fischer’s test to seekfor a possible relation between variables.Results. – Of 53 patients (42 women, 11 men, mean age 62) suffered from a with perineal neuralgia. The duration of the neuralgia was30 ± 47 months. It was bilateral in 10 cases and unilateral in 43 cases. In 43 patients with When the pain was unilateral pain, PNTML wefind that the MDLPN was increased in both sides in 39.5% of the population, in the painful side in 14% and in the side opposite side of theto pain in 11%. In 10 patients with the neuralgia was bilateral pain, in 10 patients. Among then, 4 had a bilateral increase of the latency, onepatient had an increase only on the right side, and another one an increase only on the left side. We did not find any correlation between theincreased of the PNTML TMPNL and, either neither the duration of the neuralgia nor the result of the infiltrations, whatever the method way ofthe infiltration.Conclusion. – The PNTML can be increased whether it corresponds or not to an entrapment of the pudendal nerve. Thus, the management ofperineal pain is based mainly, from us, on clinical findings.© 2006 Elsevier Masson SAS. Tous droits reserves.