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Arch Gynecol Obstet 2022 May 28. Epub 2022 May 28.

Department of Obstetrics and Gynecology, Acibadem University, Altunizade Hospital, Istanbul, Turkey.

Purpose: Pudendal neuralgia (PN) is an extremely painful neuropathy of the pudendal nerve resulting in a negative impact on a patient's quality of life. The aim of this study is to evaluate the 2-year outcomes of repetitive doses of the transvaginal pudendal nerve injections (PNI), and to compare the success of the PNI concerning anatomical levels (endopelvic and extrapelvic portion) of the pudendal nerve pathology.

Methods: This retrospective longitudinal cohort study consists of patients with PN diagnosed with the first four essential Nantes criteria. Read More

Med Clin (Barc) 2021 07 6;157(2):71-78. Epub 2021 Apr 6.

Servicio de Cirugía General y del Aparato Digestivo, Hospital Royo Villanova, Zaragoza, España.

Pudendal nerve entrapment syndrome is widely unknown and often misdiagnosed or confused with other pelvic floor diseases. The aim is to develop a diagnostic and therapeutic algorithm based on a review of the existing literature. For its diagnosis, an anamnesis will be carried out in search of possible aetiologies, surgical history, and history of pain, assessing location and irradiation, intensity on the visual analogue scale, timing, triggering factors and rule out alarm signs. Read More

Obstet Gynecol 2021 01;137(1):21-31

Division of Urogynecology and Pelvic Floor Reconstructive Surgery, Magee-Womens Hospital of UPMC, the University of Pittsburgh School of Medicine, the Department of Anesthesiology, Magee-Womens Hospital of UPMC, the Department of Anesthesiology, UPMC, and the Magee-Womens Research Institute, Pittsburgh, Pennsylvania.

Objective: To test the hypothesis that preoperative pelvic floor muscle injections and pudendal nerve blocks with bupivacaine and dexamethasone would decrease postoperative pain after vaginal native tissue prolapse repairs, compared with saline and bupivacaine.

Methods: We conducted a three-arm, double-blind, randomized trial of bilateral transobturator levator ani muscle injections and transvaginal pudendal nerve blocks before vaginal reconstructive and obliterative prolapse procedures (uterosacral ligament suspension, sacrospinous ligament fixation, levator myorrhaphy, or colpocleisis). Women were randomized to one of three study medication groups: 0. Read More

Int Neurourol J 2019 Dec 31;23(4):310-320. Epub 2019 Dec 31.

Department of Anesthesiology and Reanimation, Derince Training and Research Hospital, Kocaeli, Turkey.

Purpose: Pudendal neuralgia (PN) is a painful and disabling condition, which reduces the quality of life as well. Pudendal nerve infiltrations are essential for the diagnosis and the management of PN. The purpose of this study was to compare the effectiveness of finger-guided transvaginal pudendal nerve infiltration (TV-PNI) technique and the ultrasound-guided transgluteal pudendal nerve infiltration (TG-PNI) technique. Read More

Urology 2020 Mar 15;137:196-199. Epub 2019 Nov 15.

Beaumont Hospital, Royal Oak, MI; Oakland University William Beaumont School of Medicine, Auburn Hills, MI.

Objective: To describe a novel technique of using peripheral nerve neuromodulation (PNNM) for the treatment of refractory, mesh-induced chronic pelvic pain. Chronic pelvic pain associated with mesh can be a debilitating complication and there is currently no consensus on treatment. PNNM has been shown to be successful in the treatment of post-traumatic neuralgias but has yet to be studied in mesh complications. Read More

Rom J Anaesth Intensive Care 2017 Oct;24(2):159-162

Department of Anesthesiology and Department of Urology, Tampa General Hospital, University of South Florida Morsani College of Medicine, USA.

The pudendal nerve block (PNB) is widely used for regional anesthesia during obstetric and anorectal procedures, but its role in urologic procedures has not been thoroughly studied. While transvaginal PNB is relatively straightforward, PNB in male patients often requires imaging guidance due to difficulty appreciating anatomic landmarks. We review the PNB and relevant sonoanatomy, and describe its analgesic efficacy in three male patients undergoing urethroplasty for urethral stricture. Read More

J Obstet Gynaecol 2013 Jul;33(5):463-5

Department of Obstetrics and Gynaecology, Mid Cheshire NHS Foundation Trust, Crewe, UK. joff

Pudendal nerve blocks are a pre-requisite to forceps delivery without regional anaesthesia. Their efficacy is dependent on introducing local anaesthetic in close proximity to the pudendal nerve and allowing sufficient time for its onset of action. An audit of 57 obstetricians evaluated their clinical technique against standards using both a questionnaire and adapted model pelvis. Read More

J Gynecol Obstet Biol Reprod (Paris) 2011 May 8;40(3):225-30. Epub 2011 Apr 8.

Clinique chirurgicale de Martigues, Martigues, France.

Aim Of The Study: Describe and analyze the surgical decompression of pudendal nerve by transperineal approach using a probe with a small balloon.

Patients And Method: Since 2009 may, 43 patients (31 females, 12 males) underwent for a pudendal nerve decompression. These patients had clinical symptoms of pudendal neuralgia. Read More

Korean J Anesthesiol 2009 May;56(5):605-608

Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Pudendal nerve block (PNB) is performed for differential diagnosis and treatment of chronic pelvic and perineal pain. Several block methods, such as transvaginal, transperineal, computerized tomography-, ultrasound- and fluoroscopy-guided approach are currently under practice. Compared to others, a fluoroscopy-guided approach has several advantages, such as its relatively low cost, facility and ease of landmark recognition. Read More

Obstet Gynecol 2006 Sep;108(3 Pt 1):529-34

Department of Anatomy & Embryology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.

Objective: We investigated the clinical anatomy of the levator ani nerve and its topographical relationship with the pudendal nerve.

Methods: Ten female pelves were dissected and a pudendal nerve blockade was simulated. The course of the levator ani nerve and pudendal nerve was described quantitatively. Read More

Int J Clin Pract 2006 May;60(5):553-6

Department of Anaesthesiology and Pain Medicine, Korea University Guro Hospital, Seoul, South Korea.

Pudendal nerve block (PNB) is an effective diagnostic and/or treatment method for perineal pain. Various approach techniques, such as transperineal, transvaginal, computerised tomography (CT)- or sono-guided approach, have been suggested for this block. However, they have some limitations, such as high cost, difficulty to perform in practice, inaccurate and unreliable results and inconvenience. Read More

Obstet Gynecol 2005 Oct;106(4):782-8

Division of Urogynecology, Evanston Continence Center, and Division of Anesthesia, Northwestern University Feinberg School of Medicine, Evanston, Illinois 60201, USA.

Objective: To assess the effect of preemptive pudendal nerve blockade on pain and consumption of narcotic analgesia following transvaginal pelvic reconstructive surgery.

Methods: This was a randomized, double-blind, placebo-controlled trial. Patients undergoing transvaginal pelvic reconstructive surgery under general anesthesia were randomized to receive pudendal block with either bupivacaine 0. Read More

Anat Sci Int 2005 Sep;80(3):163-6

Ankara University, School of Medicine, Department of Anatomy, 06100 Sihhiye Ankara, Turkey.

Analgesia of the pudendal nerve is used in patients undergoing gynecologic, obstetric and penile surgery. Stimulation techniques are used to determine the functions of the nerve. In these interventions, different landmarks are used to describe the localization of this nerve. Read More

Int Urogynecol J Pelvic Floor Dysfunct 2003 Oct 7;14(4):269-75; discussion 275. Epub 2003 Aug 7.

Division of Women's Pelvic Medicine and Reconstructive Pelvic Surgery, Loyola University Medical Center, 2160 South First Avenue, Maywood, IL 60153, USA.

Several urogynecologic syndromes are associated with the clinical finding of a short, painful, tender and weak pelvic floor and a variety of connective tissue abnormalities. Techniques for rehabilitation include the avoidance of perpetuating factors, rehabilitation of extrapelvic musculoskeletal abnormalities, the use of manual techniques and needling to promote resolution of connective tissue problems, closure of any diastasis recti, and transvaginal/transrectal manual release of muscular trigger points and contractures. Therapy can be facilitated by pudendal or epidural nerve block. Read More

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