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  • Title: Pudendal neuralgia, a severe pain syndrome.
    Author: Benson JT, Griffis K.
    Journal: Am J Obstet Gynecol; 2005 May; 192(5):1663-8. PubMed ID: 15902174.
    Abstract:
    OBJECTIVE: To describe the clinical and electrodiagnostic findings, therapies, and outcomes of patients with pudendal neuralgia. STUDY DESIGN: 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%). CONCLUSION: 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.
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