Pudendal Neuralgia is pain in the distribution of the pudendal nerve and its branches. Pudendal neuralgia can be felt along the sit bones, along the rectum, along the perineum, and along the vaginal area, as well as the testicles and penis in males. Symptoms of pudendal neuralgia are achy, burning, stabbing, sharp, knife-like pains in the distribution of the pudendal nerve, which includes from the sit bones and buttocks, out to the rectum, or perineum, and/or the vaginal area, or the testes and penile area in the men. It’s often worse with sitting, as sitting does put pressure on the pudendal nerve, and it can be associated with pain with bowel movements. It is not associated with any sensory loss or sensory deficits.
Potential causes of pudendal neuralgia are anything that can put pressure along the pudendal nerve, from its course from the lower sacral nerve roots, down to the rectum and the vagina. Vaginal childbirth could put pressure on the nerve during delivery. A bladder sling operation can put pressure on the nerve and any other surgery that could cause scar tissue. Entrapment of the pudendal nerve which can come from higher up, from the lumbar sacral plexus, and injuries to the ligaments, where the pudendal nerve courses under.
The pudendal nerve can be injured. The most common way would be a stretch injury. However, the pudendal nerve, in most cases, can heal with time.