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Pudendal Neuralgia/Chronic Pelvic Pain

What is Pudendal Neuralgia?

Pudendal Neuralgia (PN) is a chronic pain syndrome involving the genital region in both men and women. The pudendal nerve provides both motor and sensory fibers to the genital area from the anal and perirectal area up to the clitoris or penis. Symptoms include pain (esp. burning) in the genital area. The symptoms decrease when sitting on a toilet seat. Patients note a change in skin sensitivity both increased and decreased. Pain with arousal, orgasm/ejaculation and erectile dysfunction is common. Urinary incontinence, urgency or frequency, as well as pain with bowel movement and constipation can occur. Women experience pain (often severe) with attempted intercourse. The condition is often disabling and prevents many normal activities.

What Causes Pudendal Neuralgia?

A variety of factors can lead to the cause of Pudendal Neuralgia. The two most common being: 

  • Nerve entrapment or compression along the course of the nerve, which causes nerve  dysfunction, pain, and Pelvic floor muscle dysfunction.
  • Connective tissue abnormalities, which causes sensitization of the nerve resulting in pain and other symptoms.

What Triggers Pudendal Neuralgia?

A large variety of triggers have been noted for nerve entrapment, most patients have an anatomical predisposition for nerve entrapment. This can be exacerbated by trauma, surgery, exercise, cycling, squatting, injury to tailbone, or chronic constipation. Nerve sensitization can be triggered by trauma, chronic skin irritations and other factors.

What Treatment Options are Available?

  • Medical Therapy
  • Physical Therapy
  • Nerve Blocks
  • Subcutaneous Infiltrations
  • Trigger Point Treatment
  • Lifestyle Modifications
  • Surgical Nerve Decompression using the approach Trans-gluteal

It is crucial to know that surgical interventions are usually not enough. Patients will greatly benefit from continued physical therapy and medical management after surgery.

Meet our Team of Specialists

We are a collection of healthcare  professionals dedicated to the comprehensive diagnosis and treatment of pudendal neuralgia and other related chronic pelvic pain issues.

Mark Conway, MD, FACOG
A gynecologist with a particular interest in pelvic reconstructive surgery and the diagnosis and treatment of pudendal neuralgia. He also offers treatment for other chronic pelvic pain issues such as vestibulodynia, vulvodynia, endometriosis and myofascial disorders.

We Also Work Closely With Physical Therapists (PT) at St. Joseph Hospital who are skilled and specially trained in treating patients with PN and other pelvic floor and myofascial disorders. As well as other PT’s out of state and a network  of pain specialists in both MA and NH.