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KMID : 1040020200110020061
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International Journal of Pain
2020 Volume.11 No. 2 p.61 ~ p.68
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Decompression of Pudendal Nerve in Chronic Pudendal Neuralgia: A Case Report
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Son Byung-Chul
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Abstract
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Pudendal neuralgia is a painful neuropathy involving the pudendal nerve. It is characterized by localized pain in the vulva, vagina, clitoris, perineum, and rectum in females and is often refractory to conservative treatment. A 71-year-old female patient presented with persistent stabbing and burning pain involving her right perineal and perianal area. The onset of pain was sudden and lasted all the time. It was more severe when lying down and sitting. No organic causes were detected in gynecological, urological, and colorectal investigations. However, the pain was refractory to various medications including anticonvulsants, analgesics, and opioids and nerve blocks. Fluoroscopy-guided pudendal nerve block resulted in temporary pain relief. Transgluteal decompression of the right pudendal nerve reduced the preoperative pain by 70%. The pain relief lasted 1 year after surgery. Chronic pudendal neuralgia that does not improve with conservative treatment suggests possible pudendal nerve entrapment.
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KEYWORD
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decompression, neuralgia, pain, pudendal nerve, pudendal neuralgia
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