Pudendal Nerve Disorders and Therapeutic Approaches

Pudendal nerve disorders encompass a spectrum of conditions characterised by pain and dysfunction arising from compression, entrapment or injury to the pudendal nerve as it traverses the pelvis and perineum. Clinically, patients present with chronic pelvic pain, perineal dysaesthesia, urinary and faecal incontinence or sexual dysfunction. Aetiologies range from obstetric trauma, pelvic surgery and repetitive microtrauma to iatrogenic injury and anatomical variations of the nerve’s course. Diagnostic evaluation integrates thorough clinical assessment—including recognition of pathognomonic signs—and neurophysiological tests such as nerve conduction studies and imaging modalities like MRI or ultrasound. Therapeutic strategies are multidisciplinary, beginning with conservative management involving physiotherapy, analgesics and lifestyle adaptations. For refractory cases, interventional techniques including targeted nerve blocks, minimally invasive decompression surgery and pulsed radiofrequency have shown promise. Emerging approaches in neuromodulation and image-guided interventions aim to enhance procedural precision and long-term outcomes. Ongoing research seeks to standardise diagnostic criteria and optimise treatment algorithms to improve quality of life for affected individuals worldwide.

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Pudendal Nerve Disorders and Therapeutic Approaches publication trend

The graph below shows the total number of articles in pudendal nerve disorders and therapeutic approaches across all publications each year (not limited to Nature Index journals).

Technical terms

Pudendal nerve: Major somatic nerve of the perineum, arising from sacral nerve roots S2–S4 and supplying sensation and motor function to pelvic structures.

Pudendal neuralgia: Chronic pain syndrome caused by irritation or compression of the pudendal nerve, characteristically exacerbated by sitting.

Pulsed radiofrequency (PRF): A neuromodulatory technique using intermittent high-frequency electrical pulses to alter pain signalling without causing thermal tissue damage.

Nerve block: Injection of local anaesthetic agents around a nerve to temporarily interrupt pain transmission.

Neuromodulation: Therapeutic modulation of nerve activity through electrical or other stimuli to alter pain pathways.

Augmented reality guidance: Use of computer-generated overlays on real-time imaging to enhance accuracy of interventional procedures.

References

1. Advances in the therapeutic approach of pudendal neuralgia: a systematic review. Journal of Osteopathic Medicine (2021).
2. Accuracy of augmented reality-guided needle placement for pulsed radiofrequency treatment of pudendal neuralgia: a pilot study on a phantom model. PeerJ (2024).
3. Fluoroscopy-Guided Transgluteal Pudendal Nerve Block for Pudendal Neuralgia: A Retrospective Case Series. Journal of Clinical Medicine (2024).
4. Peripheral nerve stimulation for pudendal neuralgia and other pelvic pain disorders: current advances. Frontiers in Urology (2023).