Pudendal Nerve Neuropathy: An Unknown-Rare Cause of Pelvic Pain.

Abstract

©2016 Turkish League Against Rheumatism. All rights reserved. Pudendal neuropathy is a rare entrapment neuropathy that is not well known in the diagnosis and differential diagnosis of pelvic pain. Pudendal nerve emerges from S2, S3, S4 nerve fibers and carries sensory information from perineal and genital organs.1 Pudendal nerve can be compressed when it passes between sacrotuberous and sacrospinous ligaments or within the Alcock canal.2 Pudendal nerve neuropathy can occur due to factors like pregnancy, fall, chronic constipation, direct trauma to pelvic region, complications that occur during surgery and excessive sportive activities like bicycle riding.1,2 International Pudendal Neuropathy Foundation estimates that incidence of this condition is 1/100,000 but true incidence rates might be higher.3 Diagnosis of pudendal nerve neuropathy is based on clinical findings and ‘Nantes’ criteria (pain on pudendal nerve region, increased pain during sitting, absence of pain which interrupts sleep, no sensation loss on clinical examination and reduced pain after pudendal block) which was published in 2008.4 Treatment options for pudendal nerve neuropathy are medical treatment, pudendal nerve blockage, decompression surgery, and neuromodulation. The most effective treatment method has not been determined yet.5