Pudendale neuralgia: Pain in the genitals and perineum
- Causes: By damage to pudendus nerve (pressure on nerve)
- Risk factors of pudendale neuralgia
- Symptoms: Pain in the genitals and perineum
- Diagnosis and investigations
- Treatment of pain, numbness and other sensations
Causes: By damage to pudendus nerve (pressure on nerve)The pudendus nerve is a nerve that extends from the pubic bone to the tailbone. The nerve sends messages to the brains of the genitals, the anus and other nearby body parts. The nerve is also responsible for the sphincters that open and close during a toilet visit. Damage or irritation to the pudendus nerve causes symptoms such as pain, discomfort and numbness to these areas.
Risk factors of pudendale neuralgiaVarious risk factors are known for the damage to the pudendus nerve. Often there is a combination of these factors:
- chronic constipation
- a birth (birth trauma)
- a history of pelvic or perineal trauma
- an infection
- a tumor that presses on the pudendus nerve (cancer or benign tumor)
- an injury
- gynecological or colorectal surgery
- repeated heavy physical exertion
- long-term cycling (cycling)
- long-term riding
- long-term sitting
- musculoskeletal problems (pain in bones, muscles and tendons, among others)
- excessive exercise
Symptoms: Pain in the genitals and perineumThe patient usually feels the symptoms of pudendale neuralgia in the lower body, namely the genitals or the perineum (the area between the genitals and the anus). The patient experiences a sharp or burning pelvic pain in these areas. The affected places are more sensitive and provide a more swollen feeling. The patient also has stinging sensations (this resembles the feeling of a sleeping leg). Sometimes numbness occurs. These sensations may worsen if the patient sits down, although sometimes it is not even possible to sit down because of the pain. Some patients also experience pain, discomfort, numbness, and sensations in the abdomen, buttocks, legs, or feet. The patient then has a sudden or frequent need to go to the bathroom (pollakisuria). He also has problems or pain during sexual intercourse and sometimes erection problems also occur.
Diagnosis and investigationsInterview
The patient informs the doctor about the location of the pain complaints. The doctor asks him questions about his medical history and lifestyle in order to get an idea about the possible cause of pudendale neuralgia.
This is followed by a physical examination. The doctor tests the neurological and musculoskeletal functions of the legs, pelvic area and perineum by checking the muscles, joints, posture and reflexes. A gynecological examination or digital rectal examination is needed to see if the nerve pain occurs when the doctor presses on the pudendus nerve with his finger.
The doctor may also start an MRI scan. This imaging research uses powerful magnets and radio waves to create an image of the internal organs of the body. Furthermore, with the help of a guided ultrasound or radiography, the patient sometimes gets a nerve block in the pudendus nerve in the pelvic area, with the aim of numbing the nerve. If the symptoms disappear as a result, then there is a real indication that the patient suffers from pudendale neuralgia.