Pudendal Neuralgia (PN) is a condition that involves pain of the pudendal nerve, which runs between the anus to the genitals of both men and women. This condition is commonly associated with pudendal nerve entrapment (PNE), or the pinching and compression of the nerve, while PN can be caused by other factors. PN is more common in women than men and can be treated through peripheral nerve hydrodissection. In the ultrasound on the right, you can see in the boxed section compression areas within the pudendal nerve. Through our image-guided process and treatment, we can target the pinched or compressed area and track the areas or release over time.
Causes for Pudendal Neuralgia
- Childbirth / Postpartum Pelvic Pain
- Entrapment (PNE)
- Pelvic Slings
- Straining from Bowel Movements
- Chronic Pelvic Floor Muscle Spasm
- Pressure on the Pudendal Nerve (common causes include Scar Tissue, Cyst, Enlarged Sacrospinous or Sacrotuberous ligament or endometriosis lesion)
Symptoms for Pudendal Neuralgia
Overall, pudendal neuralgia can result in extreme pain that makes it difficult to complete everyday tasks. Specifically, symptoms of pudendal neuralgia include:
- Aching, burning or stabbing pain in the pudendal nerve region
- Pain that increases when sitting down
- Genital pain (penis or scrotum for men, labia for women)
- Painful ejaculations
- Pain with bowel movements or urination
Pudendal neuralgia may be a sensitive matter for both men and women. When you come in for your appointment, we listen to your concerns and follow up with a series of screenings and tests to ensure a proper diagnosis of PN or PNE. Combining non-surgical options, physical therapies, and traditional medicine, we develop the best treatment plan for you.
Risk Factors for Pudendal Neuralgia
- Biking/Spinning Class
- Prolonger Sitting
- Gynecologic Disorders
- Chronic Prostatitis
- Vaginal Delivery
- PF Muscle Disorder
- Pelvic Surgery/Scarring
- Tarlov Cyst
- Lumbar Spinal Stenosis
- Prolonged Dorsal Lithotomy
Recovery Time for Pudendal Neuralgia
Often times patients ask us how long it will take for the pain of pudendal neuralgia to go away. Unfortunately, until taking a full history and examination and creating an Individualized Treatment Plan it is hard to say how long a patient will feel this pain. Our goal is to minimize the pain with our treatment protocol in conjunction with pelvic floor physical therapists and anything else we have discussed in our treatment plan. We do see a significant improvement in our patient’s symptoms and pain scores
Does Pudendal Neuralgia Go Away?
The prognosis depends on the underlying cause as well as the duration of symptoms, the most common causes being: ischemic neuropathy, stretch neuropathy, ligamentous compression, myofascial compression and compression from a hernia. Based on these causes and the underlying problem will ultimately dictate if pudendal neuralgia will go away.
Shrikhande A, Ahmed T, Shrikhande G, Hill C. A Novel, Non-Opiod Based Treatment Approach to Men with Urologic Chronic Pelvic Pain Syndrome (UCPPS) Using Ultrasound Guided Nerve Hydrodissection and Pelvic Floor Musculature Trigger Point Injections. The International Continence Society. 2018 Aug. Link to Article.