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Asian Journal of Urology, 2019, 6(4): 364-367    doi: 10.1016/j.ajur.2018.06.004
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Use of a specific questionnaire and perineal electromyography to assess neuropathic pain after radical retropubic prostatectomy
Nicolas Turmel(),Samer Sheikh Ismael,Camille Chesnel,Audrey Charlanes,Claire Hentzen,Frédérique Le Breton,Gérard Amarenco
Department of Neurourology, Tenon Hospital, GRC01 GREEN Group de Recherche Clinical Neurourology, Sorbonne University UPMC, Paris, France
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Abstract: 

Objective: Prostate cancer is the most frequent cancer in men and radical retropubic prostatectomy (RRP) is one of the first-line treatment. However, RRP has some side effects and can lead to chronic perineal pain. The objective of the study was to determine in patients suffering from perineal pain after RRP the possibility of a neurogenic damage by means of a specific questionnaire dedicated to track down neuropathic pain. Methods: Forty patients were explored by a specific and validated questionnaire, the Neuropathic Pain Symptom Inventory (NPSI). Patients were divided into two groups: Group A with an NSPI score ≥4 was considered as suffering from neuropathic pain, and Group B was considered as a control group without neuropathic pain (NSPI score <4). All patients had a perineal electrophysiological testing to confirm the possibility of a neurogenic damage. Results: Group A was composed by 13 men and Group B by 27 men, with mean age 72.45 years and mean duration of pain 2.7 years. In Group A, the most frequent symptoms were burning sensation, electrical shock and numbness. Location of the pain was global perineal area (8/13), anus (10/13), penis (5/13) and glans penis (2/13). Electromyography (EMG) findings confirmed the presence of denervation and neurogenic damages compared with controls (p < 0.001). Conclusion: One third of the patients consulting for chronic pain following RRP had probably a neuropathic lesion leading to a chronic perineal pain as suggested by an NSPI score ≥ 4 and EMG alterations.

Key words:  Prostatectomy    Neuropathic pain    Specific questionnaire    Perineal electromyography
收稿日期:  2017-07-21      修回日期:  2017-09-28      接受日期:  2018-05-04      出版日期:  2018-06-21      发布日期:  2019-09-23      整期出版日期:  2019-10-20
引用本文:    
. [J]. Asian Journal of Urology, 2019, 6(4): 364-367.
Nicolas Turmel,Samer Sheikh Ismael,Camille Chesnel,Audrey Charlanes,Claire Hentzen,Frédérique Le Breton,Gérard Amarenco. Use of a specific questionnaire and perineal electromyography to assess neuropathic pain after radical retropubic prostatectomy. Asian Journal of Urology, 2019, 6(4): 364-367.
链接本文:  
http://www.ajurology.com/CN/10.1016/j.ajur.2018.06.004  或          http://www.ajurology.com/CN/Y2019/V6/I4/364
Patient characteristics Group A (NSPI ≥4) (n = 13) Group B (NSPI <4) (n = 27) p-Value
EMG findings
Delayed sacral latencies 3 (23%) 2 (7%) 0.3
Delayed pudendal nerve terminal latencies 8 (62%) 2 (7%) <0.001
Delayed cortical evoked responses 2 (15%) 2 (7%) 0.58
Perineal muscles denervation 13 (100%) 3 (11%) <0.001
Urinary incontinence 2 (15%) 7 (26%) 0.69
Erectile dysfunction 12 (92%) 26 (96%) 1.00
  
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