Poster 192: The Incidence and Breadth of Postoperative Pudendal Nerve Palsy and Its Relationship to Table Traction During Hip Arthroscopy With a Perineal Post
Notice bibliographique
Résumé
Objectives: Pudendal nerve palsy (PNP) is a poorly characterized but common postoperative complication of hip arthroscopy (HA) with a perineal post that can result in external genital numbness and sexual dysfunction in both men and women. Previous attempts to quantify the incidence of these symptoms have relied on patient-initiated reports, chart review, unvalidated questionnaires or have neglected the female experience altogether – failures which likely underestimate the incidence of this complication. We aimed to describe the incidence of postoperative PNP, the breadth of symptoms patient experience and their duration, as well as establish the relationship between PNP and table traction. Methods: We utilized a multisurgeon prospective cohort of HA patients a single academic center. All patients underwent primary unilateral hip arthroscopy, osteochondroplasty and labral repair in a supine position with a perineal post. Patients with preexisting PNP symptoms, including sexual dysfunction, and those who were not sexually active were excluded. Intraoperative traction duration and force were recorded using a Tekscan sensor applied to the perineal post. A PNP screening questionnaire and standardized, validated sexual function questionnaires were administered confidentially to patients at 2 weeks, 6 weeks, 3 months, and 6 months postoperatively. Patient-reported hip function scores (iHOT-33) were completed preoperatively and at 6 months postoperatively. Results: A total of 100 patients were enrolled. The mean age was 36.2 ± 9.4 years old, 56 patients (56%) were male. The mean traction duration was 80 ± 19 minutes. In the acute postoperative period, 77 patients (77%) experienced symptoms consistent with PNP. The most common sensory symptom described was perineal numbness (n = 77, 77%), followed by paresthesias (n=26, 26%). Seventeen men (17%) and 13 women (13%) reported symptoms of sexual dysfunction postoperatively, in the form of erectile dysfunction (men) or reduced sexual lubrication/dyspareunia/anorgasmia (women). Of patients who experienced PNP symptoms (n = 77), 21% had symptoms resolve by 6 weeks, 71% by 3 months, 90% by 6 months. Two male patients (3.6%) had persistent erectile dysfunction beyond 6 months postoperatively. Persistence of PNP symptoms beyond 6 weeks was associated with lower 33-item International Hip Outcome Tool (iHOT-33) scores at 6 months (mean difference: 18.4 [95% CI: 6.5-30.4], p = 0.003). Analysis of the calibrated sensor data to establish the relationship between traction force, pressure, and duration with PNP is pending. Conclusions: In this preliminary analysis of a planned 100-patient cohort, patients experienced a high rate of PNP and sexual dysfunction symptoms following HA with perineal post, far higher than previous reports. Most symptoms resolved within the first 3 months postoperatively. Anticipated results from the sensor data within this ongoing study are likely to provide insight into the relationship between traction force and/or duration and PNP incidence. A postless HA setup could be considered as an alternative given the described morbidity.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,009 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».