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Dolor Pelviano Crónico

El atrapamiento del nervio pudendo produce principalmente dolor perineal y/o pelviano, en el área vaginal, labios, clítoris, pene, escroto, perine, ano, recto, sacrococcigeo, el cual puede asociarse a disfunción urinaria, anal e incluso sexual. Las tres ramas terminales poseen en diferente proporción fibras motoras, sensitivas y autonómicas. Por ello su atrapamiento puede causar signos y síntomas de expresión en cualquiera de los tres ámbitos. El dolor es la causa más común de consulta. Clásicamente se describe como dolor perineal, que se agrava al sentarse, disminuye o desaparece al estar de pie, habitualmente ausente al acostarse, y no compromete el sueño. Sensación de un objeto extraño en la vagina o recto. La mayor parte de estos pacientes tiene el tono aumentado de los músculos del suelo pelviano, Obturador Interno, restricción del tejido conectivo del área y disfunción de la articulación Sacro iliaca.

Es un problema que afecta de manera crónica a la vejiga, generando irritación e inflamación de la misma. En su gran mayoría afecta a mujeres, siendo más frecuente a partir de la tercera y cuarta década de la vida. Algunas personas con cistitis intersticial sienten sólo una incomodidad leve y otras tienen un dolor más severo. En general se presenta como la necesidad de orinar con mucha urgencia tanto de día como de noche, con aumento de la frecuencia, dolor sobre el pubis, presión o una sensación especial a nivel de la parte baja del abdomen, pelvis y periné, ardor durante o después de la micción sensación de vaciamiento incompleto.

Es un espasmo del esfínter anal que causa un dolor episódico severo a nivel rectal.


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