What exactly is Pudendal Nerve Entrapment or Pudendal Neuralgia? Since I have been broadcasting this blog to the world, many are asking. I figured I would borrow some info from the sites that helped lead to my diagnosis, TIPNA and PudendalHOPE, and put together a little blurb about what it's all about. If you want to read more about it in medical-ese, you can check out the links to these two awesome websites at the bottom of my page.Taken directly from http://pudendalhope.info
The pudendal nerve is a sensory, autonomic, and motor nerve that carries signals to and from the genitals, anal area, and urethra. There are slight differences in the nerve branches for each person but typically there are three branches of the nerve on each side of the body; a rectal branch, a perineal branch and a clitoral/penile branch. There is ongoing research into the exact areas innervated by the pudendal nerve. PN occurs when the nerve or one of its branches becomes damaged, inflamed, or entrapped.
The main symptom of pudendal neuropathy is pain in the areas innervated by the pudendal nerve or one of its branches. Possible symptoms include burning, loss of sensation or numbness, increased sensitivity, electric shock or stabbing pain, knife-like or aching pain, feeling of a lump or foreign body, twisting or pinching, abnormal temperature sensations, constipation, pain and straining with bowel movements, straining or burning when urinating, painful intercourse, and sexual dysfunction – including hyperarousal or decreased sensitivity. The pain can be on one or both sides and in any of the areas innervated by the pudendal nerve, depending on which nerve fibers and which nerve branches are affected. The symptoms can start suddenly or develop slowly over time. Often the pain gets worse as the day progresses and is worse with sitting.
There are numerous possible causes for pudendal neuropathy. Some of the possible causes are an inflammatory or autoimmune illness, frequent infections, tension on the nerve, a nerve entrapment similar to carpel tunnel syndrome, or trauma to the nerve from an accident/fall, exercise, childbirth, prolonged sitting, or surgery. Sometimes there is no apparent explanation and some doctors have theorized that the problem can be hereditary due to a musculoskeletal predisposition. Occasionally the problem originates in the spine or sacral area rather then the peripheral pudendal nerve.
The diagnosis is usually made based on the patient’s symptoms, history, and exclusion of other illnesses such as infection or tumor. While no test is 100% accurate some of the more commonly used tests are the pudendal nerve motor latency test (PNMLT), electromyography (EMG), diagnostic nerve blocks, and magnetic resonance neurography (MRN). Pudendal neuropathy can occur in men or women although about 2/3 of patients are women. It is considered rare and many doctors are just now becoming aware of this illness. Sometimes it is referred to as cyclist’s syndrome, pudendal canal syndrome, or alcock’s syndrome. Pudendal neuropathy can have similar symptoms to another disease or be misdiagnosed as another disease. Those most often associated with or confused with PN are chronic non-bacterial prostatitis, levator ani syndrome, proctalgia fugax, interstitial cystitis, vulvodynia, vestibulitis, chronic pelvic pain syndrome, hemorrhoids, piriformis syndrome, coccydynia, ischial bursitis, idiopathic (of unknown cause) orchialgia, or idiopathic prostadynia. Many PN patients have been to numerous doctors and suffered for many years before finding a diagnosis. Sadly, often PN patients are told their problem is psychological.
There are many treatment options depending on the cause of the neuropathy. The most common treatment options include pelvic floor physical therapy to relax the overly tense pelvic floor muscles, medications, pudendal nerve blocks, and if an entrapment is suspected pudendal nerve decompression surgery. Other available options are pelvic floor Botox, intrathecal pain pump, and neurostimulation. The administrators of this website are volunteers who are veterans of pudendal neuropathy.
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