Pudendal Neuralgia

Symptoms of a Pudendal Neuralgia Diagnosis:

Pudendal Neuralgia has been described as throbbing or severe stabbing pain along the pathway of the pudendal nerve that runs through the gluteal, pudendal canal and perineal region. This pain typically increases during sitting and is reduced or relieved by sitting on a toilet seat.

There are five essential criteria for diagnosis of pudendal neuralgia:

• Pain in the anatomical territory of the pudendal nerve
• Worsened by sitting
• The patient is not woken at night by the pain
• No objective sensory loss on clinical examination
• Positive anesthetic pudendal nerve block.

Other criteria that are considered complimentary include: burning, shooting, stabbing pain or numbness, allodynia, sensation of a rectal or vaginal foreign body (sympathalgia), worsening of the pain during the day, pain predominantly on one side, pain triggered by bowel movements, and tenderness to palpation along the ischial spine (on clinical exam). Associated signs and symptoms that may also be present are: buttock pain on sitting, referred sciatic pain, pain referred to the medial aspect of the thigh, suprapubic pain (pain above the pubic bone), frequent urination, pain with a full bladder, pain ocurring after ejaculation,pain during or after intercourse (dyspareunia), erectile dysfunction.

There is no sensory loss on clinical examination and an anesthetic pudendal nerve block is positive. Patients are not woken at night by pain, but do have pain during waking hours. Other clinical criteria can provide additional arguments in favor of the diagnosis of pudendal neuralgia, such as painful bowel movements or a feeling of fullness in the vaginal canal or rectum. This has also been termed Cyclists' Syndrome when it occurs in long-distance cyclists.

Contact us with any questions you may have about your Pudendal Neuralgia diagnosis. We have a number of treatment options available!