International Urogynecology Journal

, Volume 21, Issue 5, pp 613–616 | Cite as

Pudendal nerve neuromodulation with neurophysiology guidance: a potential treatment option for refractory chronic pelvi-perineal pain

Case Report


Refractory chronic pelvi-perineal pain (RCPPP) is a challenging entity that has devastating consequences for patient’s quality of life. Many etiologies have been proposed including pudendal neuralgia. Multiple treatment options are used but the reported results are sub-optimal and temporary. In this article, we present the technique of pudendal nerve neuromodulation with neurophysiology guidance as a treatment option for RCPPP. This technique is a two-step procedure that includes electrode implantation under neurophysiology guidance followed by the implantation of a permanent generator after a successful trial period. We report the cases of three women who underwent this procedure as a last-resort treatment option. After 2 years of follow-up, their symptoms are still significantly improved. No major complication occurred.


Chronic pelvic pain Neurophysiology Neurostimulation Pudendal neuralgia Pudendal nerve 


  1. 1.
    Stav K, Dwyer PL, Roberts L (2009) Pudendal neuralgia. Fact of fiction? Obstet Gynecol Surv 64(3):190–199CrossRefPubMedGoogle Scholar
  2. 2.
    Labat JJ, Riant T, Robert R, Amarenco G, Lefaucheur JP, Rigaud J (2008) Diagnostic criteria for pudendal neuralgia by pudendal nerve entrapment (Nantes criteria). Neurourol Urodyn 27:306–310CrossRefPubMedGoogle Scholar
  3. 3.
    Hough DM, Wittenberg KH, Pawlina W, Maus TP, King BF, Vrtiska TJ et al (2003) Chronic perineal pain caused by pudendal nerve entrapment: anatomy and CT-guided perineural injection technique. AJR 181:561–567PubMedGoogle Scholar
  4. 4.
    Spinelli M, Malaguti S, Giasdiello G, Lazzeri M, Tarantola J, Hombergh UVD (2005) A new minimally invasive procedure for pudendal nerve stimulation to treat neurogenic bladder: description of the method and preliminary data. Neurourol Urodyn 24:305–309CrossRefPubMedGoogle Scholar
  5. 5.
    Peters KM, Feber KM, Bennett RC (2005) Sacral versus pudendal nerve stimulation for voiding dysfunction: a prospective, single-blinded, randomized, crossover trial. Neurourol Urodyn 24:643–647CrossRefPubMedGoogle Scholar

Copyright information

© The International Urogynecological Association 2009

Authors and Affiliations

  1. 1.Department of UrologyCentre Hospitalier Universitaire de SherbrookeSherbrookeCanada
  2. 2.Department of NeurologyCentre Hospitalier Universitaire de SherbrookeSherbrookeCanada

Personalised recommendations