阴部神经调控术治疗女性阴部神经痛的疗效观察

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Efficacy of pudendal nerve modulation in the treatment of female pudendal neuralgia

ZHOU Ziqin1'² ，SONG Xin²，GU Yinjun³，LYU Tingting²，FANG Weilin²，HUANG Jin2 ，LYU Jianwei² ， CAI Zhikang² ，WANG Zhong² （1.School of Gongli Hospital Medical Technology，University of Shanghai for Science and Technology， Shanghai 200093； 2.Department of Urology，Gongli Hospital，Shanghai 200135；3.Department of Urology， Renji Hospital，School of Medicine，Shanghai Jiaotong University，Shanghai 2Ooool，China）

ABSTRACT：ObjectiveTo investigate the clinical eficacy and safety of pudendal nerve modulation （PNM） in the treatment of female pudendal neuralgia（PN），soas to promote the clinical application of this technique.MethodsA retrospective analysis was conducted on 2O female PN patients who failed conservative treatment at Gongli Hospital during Nov.2020andOct.2023.All patients underwent simultaneous PNMand sacral nerve modulation（SNM）with theassistanceof 3Dprinting navigation.Dual-stagetest electrodes forPNMandSNMwereimplanted，followedbyalternate therapeutic trial for each modality.Secondaryconversionratesand longitudinal outcomes，including visualanaloguescore（VAS），patienthealth questionnaire-9（PHQ-9），and qualityof life（QoL）scores werecompared preoperatively，post-stageI，andat3，6，and12 months post-stage ⅡI.ResultsAlloperations were succesful.After the trial phase，the secondary conversionrate for PNM was significantly higher than that for SNM;16 patients （16/20，80% ） chose the second-phase PNM implantation surgery，3（3/ 20，15% ） chose second-phase SNM implantation，and 1 （1/20，5% ）had electrodes removed due to ineffective results from both trials.Further assssentrevealedthattheimprovements inVAs，PHQ-9，and QoLscores for PNM patients were significantly better than those for SNM patients after the first phase of surgery and at 3，6 and 12 months after the second-phase conversion （ P<0.05 ）.No complications such as electrode migration or infection were observed during the follow-up of 12-15 months. ConclusionPNM provides more effective relief of pain symptoms and improvements in depresive states for female PN patientscomparedto SNM.With theasistanceof 3D printing navigation，the operation is simple and safe，andoffers stable therapeutic effects.It is worthy of clinical promotion and application.

KEY WORDS： pudendal nerve modulation; sacral neuromodulation； pudendal neuralgia； 3D printing;female摘要：目的分析阴部神经调控术（PNM）治疗女性阴部神经痛（PN）的临床疗效及安全性，以推广该术技术的临床应用。（剩余9027字）