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Lack of Continuing Education
Not reading or following medical journals

We have found that almost all doctors who treat pudendal neuralgia in the U.S. do not read published medical studies.

 

Most come from Europe, especially France where the condition was discovered, the criteria for diagnosis created, and two of the four surgical pudendal nerve decompression surgeries developed.

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This means that U.S. doctors are not aware of the newest information and treatments for pudendal neuralgia as European doctors and other around the world who read medical journals for PN info.

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Two examples of worldwide accepted standard care developed by the experts in France over a decade ago for people who may have pudendal neuralgia are not followed by most U.S. doctors that have created subordinate care for pudendal

neuralgia patients in the U.S:

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1. Diagnostic criteria for pudendal neuralgia by pudendal nerve entrapment (Nantes criteria)

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   Jean-Jacques Labat , Thibault Riant, Roger Robert, Gérard Amarenco, Jean-Pascal Lefaucheur, Jérôme Rigaud

  • Service d'Urologie, CHU Hôtel-Dieu, Nantes, France

 

Abstract

Aims: The diagnosis of pudendal neuralgia by pudendal nerve entrapment syndrome is essentially clinical. There are no pathognomonic criteria, but various clinical features can be suggestive of the diagnosis. We defined criteria that can help to the diagnosis.

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Materials and methods: A working party has validated a set of simple diagnostic criteria (The Nantes criteria).

Results: The Five Essentials Diagnostic Criteria are:

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     (1)  Pain in the anatomical territory of the pudendal nerve.

     (2)  Worsened by sitting.

     (3)  The patient is not woken at night by the pain.

     (4)  No objective sensory loss on clinical examination - Almost 0.0% of U.S. doctors conduct a physical example of patients. This means they don't know if there is sensory loss, any irregularities around the pudendal nerve or pelvic floor such as tumors, prolapses, or anything else.

     (5)  Positive Diagnostic Anesthetic Pudendal Nerve Block (PNA recommends transgluteal approach) - Regrettably, some U.S. doctors treat patients for pudendal neuralgia with injections before conducting the block. 1

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In spite of this double-blind study conducted seven years ago, we have only found one doctor who has read the study and no longer uses a steroid during the pudendal nerve block because science has proven there is not benefit. Steroids always carry risk. When we bring this to doctors' attention, they dismiss the study. It is concerning that U.S. doctors are going what they believe based on no medical evidence and going against the strongest science.

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2. Adding corticosteroids to the pudendal nerve block for pudendal neuralgia: a randomised, double‐blind, controlled trial

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BJOG. 2017 Jan; 124(2): 251–260. Wiley-Blackwell Online Open

Published online 2016 Jul 27. doi: 10.1111/1471-0528.14222

PMCID: PMC5215631 PMID: 27465823

JJ Labat, T Riant, 1 , 2 A Lassaux, 3 B Rioult, 2 B Rabischong, 4 M Khalfallah, 5 C Volteau, 6 A‐M Leroi, 7 and S Ploteau 1

Abstract

Objective

 

To compare the effect of corticosteroids combined with local anaesthetic versus local anaesthetic alone during

infiltrations of the pudendal nerve for pudendal nerve entrapment.

 

Design

Randomised, double‐blind, controlled trial.

 

Population

201 patients were included in the study, with a subgroup of 122 women.

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Conclusions

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Corticosteroids provide no additional therapeutic benefits compared with local anaesthetic and should therefore no longer be used.

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Tweetable abstract

Steroid infiltrations do not improve the results of local anaesthetic infiltrations in pudendal neuralgia. 2

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Because almost all U.S. doctors use a steroid, the facts about their efficacy are hidden from patients who believe their doctors because they are unaware of the scient study. Even when patients read the study, the disinformation form their doctors has convinced most U.S. patients that the double-blind randomized scientific study is wrong.  They follow their belief and their doctor's belief instead. The U.S. medical establishment must correct this error now.

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1 The Nantes crtiera 2007 https://pubmed.ncbi.nlm.nih.gov/17828787/

2 An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists 2016. LINK https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5215631/

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Pudendal Neuralgia Alliance

contact@pudendalneuralgiaalliance.org

© 2024 by Made with Wix ™ by volunteer Belinda Berdes

Paid for by Ms. Berdes until 501c3 established

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