[Symptomatic approach to chronic pudendal pain]

Abstract

Introduction: Pudendal neuralgia is a recently identified and now clearly recognized clinical entity. This chronic disabling pain is due to a pelviperineal tunnel syndrome.

Material and methods: Review of the literature based on a Medline search of articles devoted to this subject.

Results: The diagnosis is purely clinical, based on simple consensual criteria (Nantes Criteria): pain situated in the anatomical territory of the pudendal nerve, worse on sitting, not usually waking the patient at night, not accompanied by any objective perineal sensory loss with a positive anaesthetic block of the pudendal nerve at the ischial spine.

Conclusion: The diagnosis of pudendal neuralgia is straightforward when the patient's symptoms remain confined to these diagnostic criteria, which are all essential for the diagnosis. However, the patient often presents associated urinary, anorectal, sexual, neuromuscular and hypersensitization signs, which can complicate the diagnostic approach and therapeutic management.