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Pudendal neuropathy is any damage or disease process affecting the pudendal nerve, regardless of whether said disease process involves nerve entrapment and manifests as pain or not. It is an example of mononeuropathy (neuropathy affecting one peripheral nerve).
Pain extending outside of the vulvar vestibule may have other sources. Damage to the pudendal nerve ("pudendal neuralgia" or pudendal nerve entrapment) can cause unilateral or bilateral pain. Persistent genital arousal disorder can also cause pain in the vulvar vestibule. Spinal pathology can also cause vulvar pain. [10]
The timing/duration of symptoms may be continuous, intermittent, and/or positional. This is dependent on the underlying cause of entrapment and the specific nerves involved. For example, pain while sitting is associated with inferior cluneal nerve entrapment, pudendal nerve entrapment, and anococcyeal nerve entrapment. [11] [12] [13]
Pudendal nerve entrapment. (PNE), also known as Alcock canal syndrome, is an uncommon source of chronic pain in which the pudendal nerve (located in the pelvis) is entrapped or compressed in Alcock's canal. Abdominal. Loin pain hematuria syndrome. Proctitis—infection or inflammation of the anus or rectum. Colitis—infection or inflammation ...
In one study of 68 people with proctalgia fugax, 55 had tenderness along the course of the pudendal nerve. Pudendal nerve block relieved symptoms completely in 65% of the participants and reduced symptoms in 25%. This suggests that a major cause of proctalgia fugax may be pudendal neuralgia. [8]
pudendal nerve entrapment, ischiofemoral impingement, greater trochanter ischial impingement, and ischial tunnel syndrome. [1] Treatment: Conservative treatments include physical therapy, analgesics, and injections. [2] [4] Surgical treatment is a sciatic nerve decompression and/or muscle resection. [5]
The pudendal nerve is the main nerve of the perineum. [1]: 274 It is a mixed (motor and sensory) nerve and also conveys sympathetic autonomic fibers.It carries sensation from the external genitalia of both sexes and the skin around the anus and perineum, as well as the motor supply to various pelvic muscles, including the male or female external urethral sphincter and the external anal sphincter.
Affected women are also often hesitant to seek treatment for chronic vulvar pain, especially since many women begin experiencing symptoms around the same time they become sexually active. Moreover, the absence of any visible symptoms means that before being successfully diagnosed many patients have been told that the pain is "in their head". [20]