Pudendal neuralgia: diagnostics and treatment
The article considers the main causes of the occurrence of pudendal neuralgia. The criteria for diagnosing this state are described in detail. We present basic methods of treatment of pudendal neuralgia starting with comprehensive preservative treatment (physical therapy, medication, blockade), which in most cases are effective. And in case of its ineffectiveness or relapse of the pain syndrome, issues of conduction of pulsed RF-frequency therapy of the nerve are examined. Currently, the possibility of using hyaluronic acid preparations, botulinum toxin for the treatment of sexual neuropathy, as well as cryoanalgesia is being studying. The surgical decompression of the sexual nerve is possible in case of inefficient conservative treatment.
Benson JT, Griffis K. Pudendal neuralgia, a severe pain syndrome. AmJObstet Gynecol 2005;192:1663–68.
Popeney C, Ansell V, Renney K. Pudendal entrapment as an etiology of chronic perineal pain: diagnosis and treatment. Neurourol Urodyn 2007;26:820–7.
Shafik A. Pudendal canal syndrome as a cause of vulvodynia and its treatment by pudendal nerve decompression. Eur J Obstet Gynecol Reprod Biol 1998;80:215–20.
Labat JJ, Riant T, Robert R, et al. Diagnostic criteria for pudendal neuralgia by pudendal nerve entrapment (Nantes criteria). Neurourol Urodyn 2008;27:306–10.
Robert R, Prat-Pradal D, Labat JJ, et al. Anatomic basis of chronic perineal pain: role of the pudendal nerve. Surg Radiol Anat 1998;20:93–8.
Schraffordt SE, Tjandra JJ, Eizenberg N, et al. Anatomy of the pudendal nerve and its terminal branches: a cadaver study. ANZ J Surg 2004;74:23–6.
Hagen NA. Sharp, shooting neuropathic pain in the rectum or genitals: pudendal neuralgia. J Pain Symptom Manage. 1993; 8:496–501.
Amarenco G, Lanoe Y, Perrigot M, et al. A new canal syndrome: com-pression of the pudendal nerve in Alcock’s canal or perineal paralysis of cyclists. Presse Med 1987;16:339.
Pisani R, Stubinsky R, Datti R. Entrapment neuropathy of the internal pudendal nerve. Report of two cases. Scand J Urol Nephrol 1997;31:407–10.
Andersen KV, Bovim G. Impotence and nerve entrapment in long distance amateur cyclists. Acta Neurol Scand 1997;95: 233–40.
Silbert PL, Dunne JW, Edis RH, et al. Bicycling induced pudendal nerve pressure neuropathy. Clin Exp Neurol 1991;28: 191–6.
Ricchiuti VS, Haas CA, Seftel AD, et al. Pudendal nerve injury associted with avid bicycling. J Urol 1999;162:2099–100.
Howard EJ. Postherpetic pudendal neuralgia. JAMA 1985; 253:2196.
Amarenco G, Ismael SS, Bayle B, et al. Electrophysiological analysis of pudendal neuropathy following traction. Muscle Nerve 2001;24:116–9.
Filler A. Diagnosis and management of pudendal nerve entrapment syndromes: impact of MR neurography and open MR-guided injections. Neurosurg Q 2008;18:1–6. Hill J, Mumtaz A, Kiff ES. Pudendal neuropathy in patients with idiopathic faecal incontinence progresses with time. Br J Surg 1994;81:1494–5.
Lefaucheur JP. Neurophysiological testing in anorectal disorders. Muscle Nerve 2006;33:324–33.
Amarenco G, Kerdraon J, Bouju P, et al. Treatments of perineal neuralgia caused by involvement of the pudendal nerve. Rev Neurol 1997;153:331–4.
McDonald JS, Spigos DG. Computed tomography-guided pudendal block for treatment of pelvic pain due to pudendal neuropathy. Obstet Gynecol 2000;95:306–9.
Choi SS, Lee PB, Kim YC, et al. C-arm-guided pudendal nerve block: a new technique. Int J Clin Pract 2006;60:553–6.
Mauillon J, Thoumas D, Leroi AM, et al. Results of pudendal nerve neurolysis-transposition in twelve patients suffering from puden-dal neuralgia. Dis Colon Rectum 1999;42:186–92.
Beco J, Climov D, Bex M. Pudendal nerve decompression in perineology: a case series. BMC Surg 2004;30:4:15.
Trescot AM. Cryoanalgesia in interventional pain management. Pain Physician 2003;6:345–60.
This work is licensed under a Creative Commons Attribution 4.0 International License