open access

Vol 19 (2021): Continuous Publishing
Research paper
Published online: 2021-11-03
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Pudendal nerve block as a countermeasure to postoperative chronic pain after removal of Bartholin's cyst

Ivan Malkodanski1, Ilia Mihaylov2, Diana Strateva3, Angel Danchev Yordanov3
DOI: 10.5603/SP.2021.0012
·
Seksuologia Polska 2021;19.
Affiliations
  1. Department of Anesthesiology, Medical University Pleven, pleven, Bulgaria
  2. Medical University Pleven, pleven, Bulgaria
  3. Department of Gynaecologic Oncology, Medical University Pleven, Bulgaria

open access

Vol 19 (2021): Continuous Publishing
Prace oryginalne (nadesłane)
Published online: 2021-11-03

Abstract

The chronic pain syndrome is a serious post-operative complication. In our practice we have discovered a certain percent of neuralgia of the pudendal nerve in vaginal surgery – more precisely in Bartholin’s cyst removal. As a highly efficient countermeasure we propose a nerve block of the pudendal nerve. We have performed a retrospective study of patients who underwent a Bartholin’s cyst removal in the span of 1 year from January 1st 2019 to December 31st 2019. All of the patients included are diagnosed with chronic pain in the area innervated from the pudendal nerve. In all of the patients a pudendal nerve block with local anesthetic was performed under the guidance of ultrasound. A total of 11 patients were included in the study. There was a time interval between the Bartholin’s cyst removal surgery and the performance of the nerve block. All patients expressed moderate pain before the procedure. In only 1 case a repeat of the nerve block was imposed. There were no short- or long-term complications of any kind. The patients have been followed-up in the duration of 1 year and 100% has been reported. Accurate and precise pain assessment is vital of the diagnosing and subsequent treatment of the chronic pain syndrome. There are many ways of treating the syndrome both conventional (non-steroidal anti-inflammatory drugs, opioids, topical analgesics and adjuvant analgesics) and unconventional. Chronic pain syndrome is an important multilayered problem that requires personal approach. The nerve block of the pudendal nerve is a highly efficient method of coping with that disease.

Abstract

The chronic pain syndrome is a serious post-operative complication. In our practice we have discovered a certain percent of neuralgia of the pudendal nerve in vaginal surgery – more precisely in Bartholin’s cyst removal. As a highly efficient countermeasure we propose a nerve block of the pudendal nerve. We have performed a retrospective study of patients who underwent a Bartholin’s cyst removal in the span of 1 year from January 1st 2019 to December 31st 2019. All of the patients included are diagnosed with chronic pain in the area innervated from the pudendal nerve. In all of the patients a pudendal nerve block with local anesthetic was performed under the guidance of ultrasound. A total of 11 patients were included in the study. There was a time interval between the Bartholin’s cyst removal surgery and the performance of the nerve block. All patients expressed moderate pain before the procedure. In only 1 case a repeat of the nerve block was imposed. There were no short- or long-term complications of any kind. The patients have been followed-up in the duration of 1 year and 100% has been reported. Accurate and precise pain assessment is vital of the diagnosing and subsequent treatment of the chronic pain syndrome. There are many ways of treating the syndrome both conventional (non-steroidal anti-inflammatory drugs, opioids, topical analgesics and adjuvant analgesics) and unconventional. Chronic pain syndrome is an important multilayered problem that requires personal approach. The nerve block of the pudendal nerve is a highly efficient method of coping with that disease.

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Keywords

Key words: pudendal nerve block; chronic pain; Bartholin' s cyst; surgery

About this article
Title

Pudendal nerve block as a countermeasure to postoperative chronic pain after removal of Bartholin's cyst

Journal

Seksuologia Polska (Polish Sexology)

Issue

Vol 19 (2021): Continuous Publishing

Article type

Research paper

Published online

2021-11-03

Page views

1726

Article views/downloads

134

DOI

10.5603/SP.2021.0012

Bibliographic record

Seksuologia Polska 2021;19.

Keywords

Key words: pudendal nerve block
chronic pain
Bartholin's cyst
surgery

Authors

Ivan Malkodanski
Ilia Mihaylov
Diana Strateva
Angel Danchev Yordanov

References (7)
  1. Khandwala S, Cruff J. A Novel Method of Pudendal Nerve Blockade for Managing Pain Following Vaginal Reconstructive Surgery. Journal of Gynecologic Surgery. 2020; 36(5): 257–261.
  2. Bendtsen TF, Parras T, Moriggl B, et al. Ultrasound-Guided Pudendal Nerve Block at the Entrance of the Pudendal (Alcock) Canal: Description of Anatomy and Clinical Technique. Reg Anesth Pain Med. 2016; 41(2): 140–145.
  3. Dickson E, Higgins P, Sehgal R, et al. Role of nerve block as a diagnostic tool in pudendal nerve entrapment. ANZ J Surg. 2019; 89(6): 695–699.
  4. Anderson GV. The forgotten block. J Emerg Med. 1990; 8(4): 505–506.
  5. Fillingim RB, Loeser JD, Baron R, et al. Assessment of Chronic Pain: Domains, Methods, and Mechanisms. J Pain. 2016; 17(9 Suppl): T10–T20.
  6. Faccenda KA, Finucane BT. Complications of regional anaesthesia Incidence and prevention. Drug Saf. 2001; 24(6): 413–442.
  7. Hylands-White N, Duarte RV, Raphael JH. An overview of treatment approaches for chronic pain management. Rheumatol Int. 2017; 37(1): 29–42.

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