Modern aspects of diagnosis and treatment of urethritis associated with damage to the pudendal nerve
TL;DR
The results established that this pathological condition combines urological and neurological symptomatology and the absence of unified therapeutic standards underscores the need for further research aimed at improving diagnostic algorithms and developing pathogenetically grounded treatment methods.
Abstract
Urethritis associated with pudendal nerve injury represents an urgent and insufficiently studied interdisciplinary clinical problem. Its complexity is driven by the polymorphism of symptoms, the combination of urological and neurological pathogenetic mechanisms, difficulties in differential diagnosis, and the lack of unified standardized approaches to treatment. The aim of this study was a comprehensive analysis of current literature data on the etiology, pathogenesis, clinical manifestations, diagnostic methods, and therapeutic approaches to this pathology. The materials and methods involved a retrospective analysis of domestic and international publications indexed in the scientific electronic databases PubMed and eLibrary and addressing the issues of pudendal nerve compression and its role in the development of urogenital pathology, including urethritis. The results established that this pathological condition combines urological and neurological symptomatology. The main etiological factors include chronic nerve compression within Alcock’s canal, pelvic trauma, surgical interventions, prolonged sitting, sports-related overload, chronic constipation, neoplastic processes, and neuropathies of various origins. The clinical picture is characterized by pronounced pain syndrome in the perineal region, external genitalia, and urethra, worsening of pain in the sitting position, as well as the possible development of dysuric disorders and sexual dysfunction. The most significant diagnostic approaches include the assessment of clinical criteria (including the Nantes criteria), the use of neurophysiological methods, magnetic resonance imaging, and ultrasound examination with visualization of the pudendal nerve. Treatment includes conservative, pharmacological, physiotherapeutic, and invasive methods, the choice of which depends on the severity of symptoms and the effectiveness of the therapeutic intervention. It has been shown that the absence of unified therapeutic standards underscores the need for further research aimed at improving diagnostic algorithms and developing pathogenetically grounded treatment methods.