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OBJECTIVE: General practitioners, surgeons, neurologists, urologists and gynecologists all encounter patients suffering from neurogenic pelvic pain. Correct management demands knowledge from all above mentioned specialties. The primary goal is to help patients suffering from chronic or acute pelvic pain coupled with functional disorders like dysuria, urgency, dyspareunia, mobility disorders orhypoesthesia. Neurogenic defects are not the most common etiology for either of listed symptoms. However, after exclusion of the more common ones and failure to respond to basic therapeutic methods such as physiotherapy or analgotheraphy doctors tend to mark the illness as idiopathic and incurable. The goal of this review is to show the most common nosological units and a robust dia-gnostic algorithm to describe the type and level of the damage. METHODS: Review of literature using databases Pubmed, Science direct, Medline and sources of the international school of neuropelveology. CONCLUSION: Over a lifetime, one in seven women will suffer from chronic pelvic pain. Outside of the cases where a clear postoperative etiology is established, the time to make a correct dia-gnosis is often long for the unspecific and varied symptomatology. Neuropelveological dia-gnostic algorithm is demonstrably efficient in shortening the time to dia-gnosis and more importantly to the treatment.

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BACKGROUND: Perineuriomas are rare benign peripheral nerve sheath tumours of perineurial cell origin and can be classified into intraneural and extraneural perineuriomas. They most commonly present a mononeuropathy of gradual onset and slow progression, resulting in progressive neurological deficits like hypoesthesia or motor weakness. Therapy is still variable. Aim of the study was to compare our surgical treatment and our follow-up regime including high-resolution nerve sonography with the current literature to evaluate best treatment of perineuriomas. METHODS: Retrospective analysis of our dataset "peripheral nerve lesion" to identify patients suffering from perineuriomas between 01.01.2012 until 31.12.2018. Surgical treatment and the follow-up examination of three patients were described. Additionally, a systematic review including PubMed, the Cochrane Collaboration Library, Scopus and Google Scholar was performed for literature published between January 1, 1990 and October 31, 2019 independently by 2 authors. RESULTS: In the first case, the left ulnar nerve was affected. In the second case, the left peroneal nerve and in the third case the right median nerve was affected. High-resolution nerve sonography was performed in each case. All patients underwent interfascicular neurolysis combined with a targeted fascicular biopsy under electrophysiological monitoring. Neurological deficits improved subsidized by rehabilitation. Surgical therapy and the neurological outcome were compared with literature. Systematic review revealed 22 articles, which met the inclusion criteria. Therefore, demographics, surgical treatment and neurological outcome of 77 patients were analysed. CONCLUSIONS: Perineuriomas are rare benign nerve sheath tumours with a slow progression, sometimes difficult to diagnose. Decompression and neurolysis may improve neurological deficits. High resolution nerve sonography might serve as a helpful additional diagnostic tool in this process.

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Introduction: In teens, athletes, in general, have been found to have shoulder pain and or winging scapula resulting from long thoracic or spinal accessory nerve injuries. Accident (fall) and stretch injuries due to overuse and poor sports techniques mainly cause these injuries that affect their upper extremity movements and functions. Here, we report a significant improvement in scapula winging and shoulder active range of motion in 16 teen patients after long thoracic nerve decompression and neurolysis. Patients and Methods: This was a retrospective study of 16 teen patients who had severe winging scapula and poor shoulder movements and function. Therefore, they underwent decompression and neurolysis of long thoracic nerve with us, between 2005 and 2016. The average patient age was 17 years (range, 14-19 years). These patients had been suffering from paralysis for an average of 15 months (range, 2-48 months). All patients underwent a preoperative electromyographic assessment in addition to clinical evaluation to confirm the long thoracic nerve injury. Results: Scapula winging was severe in 10 of 16 patients (63%), moderate in 2 patients (12%), and mild in 4 patients (25%) in our present study. Mean shoulder abduction (128°) and flexion (138°) were poor preoperatively. Shoulder abduction and flexion improved to 180° in 15 patients (94%) and good (120°) in 1 patient (6%) at least 2 months after surgery. In 11 patients (69%), the winged scapula was completely corrected postsurgically and it was less prominent in other 5 patients. Conclusion: Long thoracic nerve decompression and neurolysis significantly improved scapular winging in all 16 teen patients in our present study, producing "excellent" shoulder movements in 15 patients (94%) and "good" result in 1 patient (6%).