Pudendal nerve release for lower urinary tract symptoms in young males

Aoun, Fouad; Mjaess, Georges; Akl, Bernard; Nassar, Dany; Chemaly, Anthony Kallas; Haydar, Asad; Raad, Rami; Absil, Fabienne; Nemr, Elie; Bollens, Renaud

doi:10.1111/luts.12368

Cited by 4 publications

(10 citation statements)

References 24 publications

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“…Aoun et al [ 20 ] prospectively examined LUTS refractory to medical therapy in young males who presented with some of the Nantes diagnostic criteria. The most commonly reported symptoms in this group were frequency, urgency, nocturia, and a sensation of incomplete emptying.…”

Section: Discussionmentioning

confidence: 99%

“…Finally, 70 full-text papers underwent further screening for appropriateness, leading to the exclusion of 49 additional papers. Finally, 21 papers met the inclusion criteria and were included [ 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 ]. Fig.…”

Section: Evidence Synthesismentioning

confidence: 99%

“…Among the included studies, 7 were retrospective [ 12 14 19 23 24 27 31 ], 8 were prospective [ 11 13 15 16 20 21 25 29 ], and 6 were case reports [ 17 18 22 26 28 30 ]. No randomized trials were identified.…”

Section: Evidence Synthesismentioning

confidence: 99%

“…No randomized trials were identified. The surgical techniques employed varied, with 8 studies utilizing minimally invasive surgery [ 12 15 18 19 20 23 29 30 ], while the remaining ones used transgluteal or transperineal open PNN [ 11 13 14 16 17 21 22 24 25 26 27 28 31 ]. Six studies assessed the specific site of PNE [ 11 12 13 14 15 16 ].…”

Section: Evidence Synthesismentioning

confidence: 99%

“…Six studies assessed the specific site of PNE [ 11 12 13 14 15 16 ]. LUTS was evaluated in 5 studies [ 15 17 18 19 20 ], anal or urinary incontinence in 6 studies [ 13 19 21 22 23 24 ], and sexual dysfunction in 11 studies [ 16 17 19 22 25 26 27 28 29 30 31 ]. Table 1 shows the characteristics of the included papers.…”

Section: Evidence Synthesismentioning

confidence: 99%

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Pudendal nerve neurolysis outcomes for urogenital and rectal disorders in patients suffering from pudendal nerve entrapment: A systematic review

Giulioni,

Pitoni,

Fuligni

et al. 2024

Investig Clin Urol

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Purpose Pudendal neuropathy is an uncommon condition that exhibits several symptoms depending on the site of nerve entrapment. This study aims to evaluate the efficacy of pudendal nerve neurolysis (PNN) in improving lower urinary tract symptoms, anal and/or urinary incontinence, and sexual dysfunctions. Materials and Methods A systematic literature search was performed on 20 May 2023 using Scopus, PubMed, and Embase. Only English and adult papers were included. Meeting abstracts and preclinical studies were excluded. Results Twenty-one papers were accepted, revealing significant findings in the field. The study identified four primary sites of pudendal nerve entrapment (PNE), with the most prevalent location likely being at the level of the Alcock canal. Voiding symptoms are commonly exhibited in patients with PNE. PNN improved both urgency and voiding symptoms, and urinary and anal incontinence but is less effective in cases of long-standing entrapment. Regarding sexual function, the recovery of the somatic afferent pathway results in an improvement in erectile function early after neurolysis. Complete relief of persistent genital arousal disorder occurs in women, although bilateral PNN is necessary to achieve the efficacy. PNN is associated with low-grade complications. Conclusions PNN emerges as a viable option for addressing urinary symptoms, fecal incontinence, erectile dysfunction, and female sexual arousal in patients suffering from PNE with minimal postoperative morbidity.

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Section: Discussionmentioning

confidence: 99%

Section: Evidence Synthesismentioning

confidence: 99%

Section: Evidence Synthesismentioning

confidence: 99%

Section: Evidence Synthesismentioning

confidence: 99%

Section: Evidence Synthesismentioning

confidence: 99%

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Pudendal nerve neurolysis outcomes for urogenital and rectal disorders in patients suffering from pudendal nerve entrapment: A systematic review

Giulioni,

Pitoni,

Fuligni

et al. 2024

Investig Clin Urol

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Lifelong LUTS: Understanding the bladder's role and implications across transition phases, a comprehensive review

Kheir,

Verbakel,

Wyndaele

et al. 2024

Neurourology and Urodynamics

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IntroductionLower urinary tract symptoms (LUTSs) are a diverse array of urinary and pelvic dysfunctions that can emerge from childhood, extend through adulthood, and persist into older age. This narrative review aims to provide a comprehensive perspective on the continuum of LUTS and shed light on the underlying mechanisms and clinical implications that span across the lower urinary tract.MethodsA panel of five experts from Belgium, the Netherlands, India, Denmark, and the United States participated in an intensive research to explore and pinpoint existing insights into the lifelong concept of LUTS, particularly at the pelvic level. The experts reviewed the existing literature and held a webinar to discuss their findings.ResultsChildhood LUTS can persist, resolve, or progress into bladder underactivity, dysfunctional voiding, or pain syndromes. The Lifelong character can be explained by pelvic organ cross‐talk facilitated through complex neurological and nonneurological interactions. At the molecular level, the role of vasopressin receptors in the bladder's modulation and their potential relevance to therapeutic strategies for LUTS are explored. Frailty emerges as a parallel concept to lifelong LUTS, with a complex and synergistic relationship. Frailty, not solely an age‐related condition, accentuates LUTS severity with insufficient evidence regarding the effectiveness and safety profile of the available therapeutic modalities.ConclusionUnderstanding lifelong LUTSs offers insights into genetic, anatomical, neurological, and molecular mechanisms. Further research could identify predictive biomarkers, elucidate the role of clinically translatable elements in pelvic cross‐talk, and uncover molecular signatures for personalized management.

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