MVD is the preferred first-line surgical treatment when pharmacological therapy fails, vascular compression is present, and the patient is a suitable candidate for surgery. In cases where MVD is contraindicated or vascular compression is absent, alternative treatments should be considered based on individual patient factors, balancing efficacy and long-term outcomes. Further high-quality studies are needed to refine treatment strategies for GPN.
Rohde et al. (Sun,) studied this question.