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Pudendal Neuralgia

Pudendal Nerve Entrapment, Alcock Canal Syndrome, and Pudendal Canal Syndrome

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Genitourinary Pain And Inflammation

Part of the book series: Current Clinical Urology ((CCU))

Summary

Pudendal neuralgia is a peripheral neuropathy of the pudendal nerve, generally due to compression between the sacrotuberous and sacrospinous ligaments. It is a tunnel syndrome. We have treated persons of both genders between 14 and 87 years of age. The characteristic symptoms are pelvic pains that are aggravated by sitting and driving and reduced by sitting on a toilet seat. Bowel, bladder, and sexual dysfunctions are common. The diagnosis is confirmed at physical examination of the pudendal sensory nerves. Objective neurophysiological tests include quantitative sensory testing of warm detection threshold and the pudendal nerve terminal motor latency test. Pudendal neuralgia is caused by repetitive flexion of the hip as in exercise and athletics, childbirth, sitting, and cycling. Treatment of pudendal neuralgia is analogous to treatment of the carpal tunnel syndrome. Nerve damage is prevented by a self-care protection program. When necessary, pudendal nerve perineural injection (PNPI) of local anesthesia and corticosteroids is necessary. Thirty percent or more patients require decompression surgery of the pudendal nerves. Each of these sequential treatments can provide prolonged relief of more than 5 years.

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Authors
  1. Stanley J. Antolak Jr. MD
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Editors and Affiliations

  1. Glickman Urologic and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA

    Jeannette M. Potts MD

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Antolak, S.J. (2008). Pudendal Neuralgia. In: Potts, J.M. (eds) Genitourinary Pain And Inflammation. Current Clinical Urology. Humana Press. https://doi.org/10.1007/978-1-60327-126-4_3

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  • DOI: https://doi.org/10.1007/978-1-60327-126-4_3

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-816-4

  • Online ISBN: 978-1-60327-126-4

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