Evidence and experience
What the evidence and two decades of surgical experience say about pudendal neuralgia.
Pudendal neuralgia is a chronic pain condition caused by irritation, compression or entrapment of the pudendal nerve — the nerve that supplies sensation to the perineum, genitals and rectum. Because that nerve runs a long and narrow course through the pelvis, it can be trapped at several different points, and each point produces a slightly different pattern of pain.
The classic picture is pain that worsens when sitting and eases when standing, lying down or sitting on a toilet seat. Patients describe burning, stabbing or electric sensations, a feeling of a foreign object in the rectum or vagina, and urinary urgency or sexual dysfunction that no scan seems to explain.
Prof. Dr Renaud Bollens, professor of urology at Pelvic Institute, has performed more than 600 pelvic procedures and dedicates his practice exclusively to complex pelvic pain. His assessment combines a detailed symptom history, targeted clinical examination, imaging review and — when appropriate — diagnostic nerve blocks to confirm which segment of the nerve is involved before any surgery is discussed.
Dr Bollens is a professor of urology, a proctor in pelvic surgery and a published author on pudendal neuralgia.