Journal
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
Volume 192, Issue 5, Pages 1663-1668Publisher
MOSBY, INC
DOI: 10.1016/j.ajog.2005.01.051
Keywords
pudendal neuralgia; electrodiagnosis; pudendat injection; pudendal decompression; pudendal neuromodulation; outcomes
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Objective: To describe the clinical and electrodiagnostic findings, therapies, and outcomes of patients with pudendal neuralgia. Study design: A retrospective, descriptive study of 64 patients from March 19 to December 22, 2003. Results: Clinical findings included pain along nerve distribution (64, 100%), pain aggravated by sitting (62, 97%), pain relieved by standing or lying (57, 89%), and misdiagnosis (53, 83%). Neurophysiologic findings were normal (23, 35%), demyelination (17, 26%), axonal loss (5, 7.5%), and demyelination with axonal loss (21, 32%). Therapies were conservative (64, 100%), nerve injection (38, 59%), neuromodulation (2, 3%), and decompression surgery (10, 15%). Slight or moderate pain improvement with therapies included conservative (64, 100%), nerve injection (12, 31%), neuromodulation (2, 100%), and decompression (6, 60%). Conclusion: Pudendal neuralgia-is poorly recognized and poorly treated. Improvement is gained with conservative therapy. Injections and decompression benefit one half and one third of patients, respectively. Neuromodulation needs further evaluation. (c) 2005 Elsevier Inc. All rights reserved.
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