Modern principles of surgical treatment of pudendal neuralgia (review)

Objective: to analyze the literature data on the effectiveness of modern methods of surgical treatment of pudendal neuropathy to select the most optimal of them. To write the review we studied databases: PubMed, MEDLINE, Cohrane Library, eLibrary using keywords: "pudendal neuralgia", "surgical treatment", "open decompression of the pudendal nerve", "pulse radiofrequency denervation". Depth of search: from 1966 to 2022. The number of analyzed sources was 75. Thirty nine were selected for the review.. Despite the availability of a variety of surgical interventions, so far we have not been able to achieve the most positive results of treatment of this pathology. Open decompression of the genitourinary nerve, while having satisfactory treatment results, simultaneously increases the probability of postoperative complications. Sacral stimulation and pudendal nerve stimulation have fewer complications, but are characterized by ambiguous results. The use of pulsed radiofrequency denervation of the pudendal nerve leads to a significant regression of the pain syndrome in the postoperative period and, due to the least invasiveness, practically has no postoperative complications. However, the samples of patients treated by this method presented in the literature are too few for an unambiguous judgment. Therefore, the question of choosing the most effective method of surgical aid in pudendal nerve neuropathy remains open.