Alcock's canal syndrome. Helen Stanbro
The Doctors
My mother has been diagnosed with alcock's-canal syndrome.
A vascular condition? Do you know anything about it as the doctors here
aren't
that confident, they have already blocked off an artery which has
actually made
her pain worse. What can be done to help her?
ANSWER by Helen Stanbro, M. Phil.
Usually this is a nerve compression syndrome. Surgical decompression can
be
tried, but sometimes the scar tissue after the surgery causes more
compression of
its own.
Here is another therapeutic approach:
Ann Urol (Paris) 1989;23(6):488-92
[Perineal neuralgia and Alcock's canal syndrome].
[Article in French]
Amarenco G, Savatovsky I, Budet C, Perrigot M
Laboratoire d'Urodynamique et d'Electrophysiologie, CHG Robert
Ballanger, Aulnay Sous Bois.
Perineal neuralgia is characterised clinically by pain (burning
type of
perineal pain) exacerbated in the sitting position. It is
secondary to impairment of the internal pudendal nerve in its
musculo-osteo-aponeurotic tunnel composed by the ischium and
the obturator internus muscle (ischiorectal fossa or pudendal
canal).
As in any nerve tunnel syndrome, pre-existing neuropathy
constitutes a predisposing factor and should therefore be
identified.
The diagnosis of pudendal tunnel syndrome is confirmed by
perineal electrophysiological investigations (detection of
neurogenic
muscles of the perineal floor, increased sacral latency).
Treatment consists of infiltration, possible repeated, of the
pudendal
tunnel with a sustained-release corticosteroid under CT
guidance.
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