A Simple Guide to Pudendal Neuralgia, Diagnosis, Treatment and Related Conditions

By Kenneth Kee

This book describes Pudendal Neuralgia, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic

Pudendal neuralgia is a disorder characterized by chronic pain in the pudendal nerve, which is a major nerve that supplies sensation to the genital area, perineum, and anus.

Pudendal neuralgia is long-term pelvic pain that originates from damage or irritation of the pudendal nerve which supplies areas including the:
Lower buttocks
Area between the buttocks and genitals (perineum)
Area around the anus and rectum
Vulva, labia and clitoris in women
Scrotum and penis in men

Simply put the pudendal neuralgia is a pain in the butt!

Pudendal neuralgia can occur in male and female even though about 67% of patients are female.

Internationally there is no racial or ethnic group preference observed.

Causes:

Pudendal neuralgia can take place if the pudendal nerve is injured, irritated or compressed.

Nerve entrapment:
Compression of the pudendal nerve by nearby muscles or tissue (Alcock canal syndrome)

Nerve irritation or injury:
Trauma, repetitive strain, childbirth, or surgery in the pelvic area can lead to nerve irritation or injury.

Inflammation:
Disorders like pelvic inflammatory disease or chronic inflammation of the pelvic organs can cause pudendal neuralgia.

Idiopathic:
In some patients, the cause may not be known.

Risk Factors:
Pelvic trauma and surgery
Prolonged sitting
Repetitive activities

Other risk factors are:
A non-cancerous or cancerous growth pressing on the pudendal nerve
Excessive physical exercise
Past pelvic or perineal trauma
Straining
Musculoskeletal issues
Posture
Stress

Pudendal neuralgia pain may:
Have a burning, crushing, shooting or prickling sensation
Develop gradually or suddenly
Be continuous but may become worse at some times and better at others
Be worse when sitting down and disappear when standing or lying down

Additional symptoms are pain during sex and needing to urinate frequently and urgently.

Pinprick sensation is examined at each branch bilaterally:
Dorsal nerve (clitoris and glans penis),
Perineal nerve (posterior labia and posterior scrotum) and
Inferior anal nerve (posterior perianal skin).

Diagnostic criteria are often used.
Pain limited to the region of innervation of the pudendal nerve
Pain predominant during sitting
Pain does not awaken the patient from sleep
No objective sensory defects
A positive effect of anesthetic infiltration of the pudendal nerve

Unfortunately there is no “cure” for pudendal neuralgia.

At present the medical treatments of pudendal neuralgia involve drug therapy, pudendal nerve block, and nervous regulation by the implanted pulse generator, radiofrequency ablation, spinal cord electrical stimulation, pudendal nerve decompression.

Physical therapy with specialists in pelvic floor therapy is often the first line of treatment.

Patients are also given exercises and lifestyle modifications to use at home.
Manage the sitting position with coccyx-cut-out memory foam cushions
Proper the bladder or bowels emptying
Other conservative treatments involve heat, massage, rest, TENS, muscle relaxants and anti-inflammatory medicines

Injection of local anesthetics or steroids around the pudendal nerve can provide temporary relief.

Surgical intervention, such as pudendal nerve decompression or neurectomy, may be indicated in severe or refractory cases

TABLE OF CONTENT
Introduction
Chapter 1 Pudendal Neuralgia
Chapter 2 Cause
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Occipital Neuralgia
Chapter 8 Trigeminal Neuralgia
Epilogue

• Language: English
• Publisher: Kenneth Kee
• Release date: Jul 3, 2023
• ISBN: 9798215313749

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

Book preview

A

Simple

Guide

To

Pudendal Neuralgia,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B., B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2023 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes Pudendal Neuralgia, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What You Need to Treat A Pain in the Butt)

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Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog: http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiography account of my journey as a medical student to family doctor on my other blog: http://afamilydoctorstale.blogspot.com.

This autobiography account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 800 eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical disorders.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

My diagnosis and treatment capability has improved tremendously from my continued education.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Pudendal neuralgia

What is Pudendal neuralgia?

Pudendal neuralgia is a disorder characterized by chronic pain in the pudendal nerve, which is a major nerve that supplies sensation to the genital area, perineum, and anus.

Pudendal neuralgia is long-term pelvic pain that originates from damage or irritation of the pudendal nerve which supplies areas including the:

1. Lower buttocks

2. Area between the buttocks and genitals (perineum)

3. Area around the anus and rectum

4. Vulva, labia and clitoris in women

5. Scrotum and penis in men

The pudendal nerve transmits the sensation of touch and pain from the skin between the anus and the clitoris (females)/penis (males) and the sphincters (muscles keeping bladder and bowel closed).

Pudendal neuralgia is occasionally called the cyclist’s syndrome, pudendal canal syndrome, or Alcock’s syndrome.

Pudendal neuralgia is distinguished by pelvic pain, including bowel, bladder regional pain or discomfort, sexual dysfunction, vulvar or penial pain, severe burning sensations and needle-like pain, which are exacerbated when seated and relieved after standing.

Pudendal neuralgia is characterized by burning vaginal or vulvar pain (anywhere between the anus and the clitoris) linked with tenderness over the course of the pudendal nerve.

Pudendal neuralgia may be connected to childbirth, pelvic surgery, strenuous exercise, abnormalities of the sacroiliac joint.

Pudendal neuralgia is linked to age-related changes.

Incidence

The incidence of pudendal neuralgia is about 1 in 100,000 people in the general population.

Pudendal neuralgia may be observed in persons of any age group

Pudendal neuralgia can occur in male and female even though about 67% of patients are female.

Internationally there is no racial or ethnic group preference observed.