Surgical Decompression of Pudendal Nerve by Transperineal Approach Using a Balloon Probe

Since 2009 may to 31 january 2012, 512 patients (371 females, 141 males) have benefited from a pudendal nerve (PN) decompression by transperineal approach using a ballon probe. These patients had clinical symptoms of pudendal neuralgia. Neurophysiological tests based on the staged sacral reflexes, on ultrasound investigations of pudendal vessels and on a pelvic floor ultrasounds evoked a zone of compressive hyperpressure at the level of the axis infrapiriformis area-ischiorectal fossa. All of these 512 patients, injection block at the level of the infrapiriformis area appeared positive between 1 to 9 months. Patients were known for this pathology since many years. Among these 512 patients, 66 had already PN decompression, 27 by transgluteal approach, 36 by transvaginal (♀)/transischiorectal (♂) approach and 3 by transperineal approach (Shakik extended) but without clinical efficiency.All of these 512 patients, surgical decompression was done by transperineal approach using a balloon probe.Surgical methodology, post-op follow up and results are reported hereby, which appear quite successful with few risks to make worse the pathology and no risk on pelvic static.