Pudendal Neuralgia

The pudendal nerve provides sensory input for both male and female external genitalia. Symptoms of pudendal neuralgia include burning, numbness, tingling, and paresthesias in the pelvic and perineal regions. It is commonly caused by inflammation, pudendal nerve entrapment, or nerve compression at the sacrospinous and sacrotuberous ligaments. It is typically diagnosed clinically; however, imaging and nerve blocks serve as important diagnostic tools as well. Management with nonopioid medications and physical therapy are the mainstay approach to pudendal neuralgia. When conservative treatment does not provide adequate pain relief, interventional options such as radiofrequency ablation and neuromodulation implantable therapies are considered.