Pudendal neuralgia

Pudendal neuralgia (PN) results from damage, irritation, or compression of the pudendal nerves.

Symptoms of PN:

1- Burning pain, often one-sided, in the perineal region
- Tingling or numbness in the buttock, vulva, perineum
Symptoms usually get worse while sitting and may subside while standing or lying down
2 - Sexual dysfunction (pain during intercourse), genital pain in women and erectile dysfunction in men
3 - Sphincter dysfunction - constipation, fecal incontinence, urination disorders
4 - Sensation of a foreign body in the anus, vagina


PN can develop as a result of mechanical as well as non-mechanical damage to the pudendal nerves. The most common cause of mechanical damage is the compression of the pudendal nerves. Non-mechanical damage to the pudendal nerves can develop as a result of a viral infection (HIV, herpes zoster), multiple sclerosis, diabetes mellitus, etc.

The reasons for the development of PN can be
- previous surgery in the pelvic area
- direct injury of the buttocks
- natural delivery
- chronic constipation
- long cycling
- motorcycling

Treatment options

1) Drug treatment - analgesics, muscle relaxants, anticonvulsants (gabapentin, pregabalin).
2) Pudendal nerve blockade using local anesthetics and/or corticosteroids. Blockade must be performed under X-ray or ultrasound navigation control in order to minimize the risk of complications.
3) Pulse radiofrequency treatment of pudendal nerves.
4) Cryoanalgesia is a relatively new method, it means exposing the pudendal nerves to low (up to -80° C) temperature.


Pudendal neuralgia is a chronic disease, relapses may alternate with periods of remission. The condition considerably reduces the quality of life of patients and often leads to the development of depressive disorders.