Pudendal Neuralgia
- DOI:
- 10.1093/med/9780199393039.003.0010
Pudendal neuralgia is pain in the dermatomal distribution of the pudendal nerve. Symptoms include pain, tingling, or burning in the clitoris/penis, vagina/scrotum, perineum and/or rectum. Pudendal neuralgia is often associated with other pelvic pain conditions and therefore has a broad spectrum of presentations. It is confused with diseases such as vulvodynia, prostatodynia, vaginismus, levator ani syndrome, and painful bladder syndrome. In this chapter we will use the term pudendal neuralgia strictly as a symptom. This definition is in contrast to pudendal nerve entrapment: compression or impingement of the nerve. The Nantes criteria offer a reproducible way to diagnose pudendal neuralgia. Conservative therapies such as avoidance, lifestyle modifications, and medications are preferred. Surgical decompression is reserved for patients who have failed medical management. Pudendal neuralgia should be suspected in patients complaining of genital and rectal pain without an identifiable cause, to insure prompt referral, patient education, and treatment.
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