Pudendal nerve block as a countermeasure to postoperative chronic pain after removal of Bartholin's cyst
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.
Keywords: Key words: pudendal nerve blockchronic painBartholin's cystsurgery
References
- 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.
- 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.
- 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.
- Anderson GV. The forgotten block. J Emerg Med. 1990; 8(4): 505–506.
- Fillingim RB, Loeser JD, Baron R, et al. Assessment of Chronic Pain: Domains, Methods, and Mechanisms. J Pain. 2016; 17(9 Suppl): T10–T20.
- Faccenda KA, Finucane BT. Complications of regional anaesthesia Incidence and prevention. Drug Saf. 2001; 24(6): 413–442.
- Hylands-White N, Duarte RV, Raphael JH. An overview of treatment approaches for chronic pain management. Rheumatol Int. 2017; 37(1): 29–42.
![](https://journals.viamedica.pl/plugins/generic/popups/images/icons/close.png)