Pudendal Neuralgia

Pudendal neuralgia is a condition that causes painful nerve inflammation. The pudendal nerve carries signals to and from the genitals, anal area and urethra. If excessive pressure is placed on the pudendal nerve as it travels through the pelvic floor, it can cause a burning pain anywhere in the region. The affected area is often sensitive to the touch, and discomfort often increases when of sitting. The symptoms of pudendal neuralgia may start suddenly or develop slowly.

Causes of Pudendal Neuralgia

Although its exact cause is not known, pudendal neuralgia may be caused by the following:

  • Pregnancy
  • Childbirth
  • Thickened ligaments
  • Scar tissue from previous surgery
  • Injury

Pudendal neuralgia may also be caused by repeated vaginal infections or chronic constipation.

Symptoms of Pudendal Neuralgia

Symptoms caused by pudendal neuralgia often include pain, numbness, burning and tingling, particularly when sitting, in the clitoris, vulva, perineum and rectum. Some women with pudendal neuralgia may have pain during intercourse; a burning sensation while urinating; and urinary incontinence.

Diagnosis of Pudendal Neuralgia

Pudendal neuralgia is diagnosed through a pelvic examination and a review of symptoms. Blood and urine tests may be administered to check for signs of infection, and rule out any underlying conditions. Additional diagnostic tests may include the following:

  • CT scan
  • MRI scan
  • Electromyogram

Electrophysiological tests may also be administered to check nerve and sensory function of the pelvic floor.

Treatment of Pudendal Neuralgia

A pudendal nerve block, which is an injection of corticosteroids to disrupt nerves signals, may be used to confirm the diagnosis. If the nerve block is successful in relieving pain, it can help determine that pudendal nerve compression is the cause, and can subsequently be used as a form of treatment. Other treatment methods may include the following:

  • Avoiding activities that can worsen symptoms
  • Muscle relaxants
  • Pain medication, including topical lidocaine
  • Physical therapy

In severe cases, surgery may be recommended as a last resort to relieve the compression on the pudendal nerve.

Additional Resources