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The patient has suffered for several years a strong neuropathic pain in the hip and gluteal area due to a neurostenalgia of the sciatic and pudendal nerves. This nervous condition causes inability to sit or adopt any posture that involves hip flexion without pain, but can be eliminated by surgery.

The problem

The area of ​​hips, buttocks and perineum presents a high concentration of blood vessels and nerves. Thus, the sciatic and the minor sciatic nerves provide sensitivity to the back of the thigh, buttock and perineum, and to the entire leg and foot. The pudendal nerve does the same with the anus, the lateral wall of the vagina and the back of the penis. sciatic nerve

These nerves can present adhesions by fibrous bands in their path, that is they can ‘stick’ to other elements of the musculoskeletal structure, which causes irritation and pain by preventing their normal sliding.

In this case, Dr. Piñal faces a disabling pain picture in a patient hopeless after several unsuccessful operations, and who only found partial relief with medication (opiates, antiepileptic and tranquilizers) in the Palliative Care Unit.

The goals

The goals of the Spanish surgeon and his surgical unit seek to release the affected nerves, returning the patient to a situation of normal mobility and absence of pain.

The plan

The high density of important elements in aspects such as walking, the possibility of sitting or the maintenance of satisfactory sexual relations give the intervention in this environment a certain complexity. Thus, Dr. Piñal designs a precise surgical procedure that eliminates preexisting adhesions.

The results

The procedure is executed successfully. The patient had a real problem that was controlled by microsurgery on the sciatic and pudendal nerves. A few days later, even before removing the stitches, the patient can sit down again, squat, etc. without returning to the previous serious pains.