Pudendal neuralgia, a severe pain syndrome.
OBJECTIVE
To describe the clinical and electrodiagnostic findings, therapies, and outcomes of patients with pudendal neuralgia.


METHODS
A retrospective, descriptive study of 64 patients from March 19 to December 22, 2003.


RESULTS
Clinical findings included pain along nerve distribution (64, 100%), pain aggravated by sitting (62, 97%), pain relieved by standing or lying (57, 89%), and misdiagnosis (53, 83%). Neurophysiologic findings were normal (23, 35%), demyelination (17, 26%), axonal loss (5, 7.5%), and demyelination with axonal loss (21, 32%). Therapies were conservative (64, 100%), nerve injection (38, 59%), neuromodulation (2, 3%), and decompression surgery (10, 15%). Slight or moderate pain improvement with therapies included conservative (64, 100%), nerve injection (12, 31%), neuromodulation (2, 100%), and decompression (6, 60%).


CONCLUSIONS
Pudendal neuralgia is poorly recognized and poorly treated. Improvement is gained with conservative therapy. Injections and decompression benefit one half and one third of patients, respectively. Neuromodulation needs further evaluation.
Benson
Jesse Thomas
JT
Department of Obstetrics and Gynecology, Indiana University/Methodist Hospital, Indianapolis, USA.
Griffis
Kenneth
K
D000328:Adult; D000368:Aged; D001369:Axons / Q000473:pathology; D019299:Decompression, Surgical; D003711:Demyelinating Diseases / Q000473:pathology; D003951:Diagnostic Errors; D004599:Electric Stimulation Therapy; D004568:Electrodiagnosis; D005260:Female; D005835:Genitalia / Q000294:innervation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology* / Q000628:therapy*; D010166:Palliative Care; D010502:Perineum / Q000294:innervation*; D012007:Rectum / Q000294:innervation*; D012189:Retrospective Studies; D013577:Syndrome