Robot-assisted pudendal neurolysis in the treatment of pudendal nerve entrapment syndrome

Abstract Introduction Pudendal nerve entrapment syndrome (PNE) is characterized by the presence of neuropathic pain in the pudendal nerve (PN) territory, associated or not with urinary, defecatory and sexual disorders. Surgical PN decompression is an effective and safe alternative for cases when conservative treatment fails. The aim of this study is to describe the first robot-assisted pudendal neurolysis procedure performed in our country. Material and methods We describe step by step the technique of robot-assisted laparoscopic neurolysis of the left PN performed with intraoperative neurophysiological monitoring on a 60-year-old patient diagnosed with left PNE. Results The procedure was performed satisfactorily without complications. After 24 h, the patient was discharged from the hospital. We observed a 50% reduction in pain measured using the visual analog scale 2 weeks after the procedure, which remained after 10 weeks of the neurolysis. Conclusions Robot-assisted neurolysis of the PN constitutes a feasible and safe approach, enabling better visualization and accuracy in the dissection of the PN. Intraoperative neurophysiological monitoring is useful for locating the PN and for detecting intraoperative changes after the release of the nerve.