FAQs on Pudendal Neuralgia
Pudendal neuralgia is a painful neuropathic condition caused by inflammation of the pudendal nerve. The pudendal nerve is located in the pelvic cavity and it carries sensory and motor fiber information. Pudendal neuralgia can be related to entrapment, dysfunction, or compression of the nerve.
What causes pudendal neuralgia?
Pudendal neuralgia is pain that lasts three or more months. Trauma to the pudendal nerve can trigger the onset of this condition. Pudendal neuralgia is caused by:
• Trauma during childbirth
• Sacroiliac joint dysfunction
• Chronic constipation
• Repetitive vaginal infections
• Surgery
• Cycling
• Direct falls onto the tailbone (coccyx)
What are the symptoms of pudendal neuralgia?
The symptoms of pudendal neuralgia include pain with sitting that increases through the day, perineal, rectal, and penile discomfort, difficulty with urination, problems with defecation, and sexual dysfunction. The pain can occur with or without touch. Men often describe pain during erection and painful ejaculation. One common symptom of women is the sensation of a foreign object being inside the body. The pain of pudendal neuralgia is not immediate, but often delayed. It can be long-standing, and the skin in this region is often hypersensitive to pressure or touch.
How common is pudendal neuralgia?
According to the International Pudendal Neuropathy Association, the incidence of pudendal neuropathy is 1 in 100,000 persons. Most practitioners who treat patients with this condition report that the incidence may be higher.
How is pudendal neuralgia diagnosed?
The pain associated with pudendal neuralgia often leads people to go see a specialist. If you are experiencing pain, the doctor will take a detailed medical history. The doctor will conduct many tests to assess for other conditions as well. These include urinalysis, cultures, ultrasounds, cystoscopes, and x-rays. Some tests used to diagnose pudendal neuropathy include a magnetic resonance neurography (MRN), as well as an image-guided pudendal nerve block. The final diagnosis is based on meeting certain criteria, such as presence of pudendal neuralgia symptoms, MRN confirming the condition, elimination of other conditions, and a positive response to the nerve block.
What are the treatment options for pudendal neuropathy?
Pudendal neuropathy treatment is complex because of the functions and location of the nerve. Treatment options include:
• Lifestyle changes – Weight loss and exercise helps relieve pressure on the nerve.
• Pelvic floor physical therapy – The therapist works with the patient to learn certain pelvic floor exercises to ease pain and improve function.
• Surgery – The surgeon can remove scar tissue when there is pressure on the nerve.
• Nerve blocks – A nerve block can alleviate the pain associated with PN for several weeks.
• Pain medications – Medications are used for muscle spasms, pain, and inflammation. Nerve pain also responds to antidepressants and anticonvulsants.
Does stem cell therapy help pudendal neuralgia?
In a study involving treatment of pudendal neuralgia with stem cells, researchers conducted EMG studies after therapy. They found that stem cells preserved neurological function and facilitated neuroregeneration (new nerve growth). In addition, stem cell therapy appeared to recover function of the sensory branch of the pudendal nerve. In a study involving 15 women with pudendal neuralgia not response to medical therapy, researchers used stem cells for pudendal nerve lipofilling. Researchers found that this procedure had a low risk of complications, and patients enjoyed improvement of symptoms following a short treatment period.
There have been two groundbreaking studies over the last few years performed regarding stem cell therapy for pudendal neuralgia. The specifics of those studies are discussed HERE.
Call (844) GET-STEM to receive a complimentary evaluation at the R3 Stem Cell Center of Excellence nearby!
Resources
Damaser M, Lin DL, Hanzlicek, B, et al. (2015). Mesenchymal stem cells facilitate pudendal nerve recovery from simulated childbirth injury. Retrieved from: https://www.ics.org/Abstracts/Publish/134/000177.pdf
Venturi M, Boccasanta P, Lombardi B, et al. (2015). Pudendal Neuralgia: A New Option for Treatment? Preliminary Results on Feasibility and Efficacy. Pain Med, 16, 1475-1481.