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Pudendal neuralgia.

M L Turner1, S C Marinoff

  • 1Center for Vulvovaginal Disorders, George Washington University Medical School, Washington, D.C. 20037.

American Journal of Obstetrics and Gynecology
|October 1, 1991
PubMed
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Pudendal neuralgia, pain along the pudendal nerve, may cause chronic vulvar burning (vulvodynia) in patients without clear infections or physical findings. Treatment with antidepressants or antiepileptic drugs can help manage this nerve pain condition.

Area of Science:

  • Neurology
  • Gynecology
  • Pain Medicine

Background:

  • Chronic vulvar burning, known as vulvodynia, often lacks identifiable causes like infections or physical abnormalities.
  • Patients may present with sensory disturbances including allodynia, hyperalgesia, hyperpathia, and hypoesthesia in the pudendal nerve distribution.
  • Idiopathic vulvodynia presents a diagnostic challenge, necessitating exploration of underlying neurological mechanisms.

Purpose of the Study:

  • To propose pudendal neuralgia as a potential cause of idiopathic vulvodynia.
  • To highlight the diagnostic utility of sensory testing in identifying nerve-related vulvar pain.
  • To inform clinicians about a treatable neurological condition underlying vulvodynia.

Main Methods:

  • Clinical observation of patients with chronic vulvar burning.

Related Experiment Videos

  • Sensory testing to evaluate nerve function in the vulvar region.
  • Differential diagnosis to exclude other causes of neuralgia.

    • Main Results:

    • Patients exhibited sensory abnormalities consistent with pudendal nerve involvement.
    • Pudendal neuralgia was identified as a plausible cause for vulvodynia in a subset of patients.
    • Absence of neurological, metabolic, infectious, traumatic, or malignant etiologies for neuralgia was noted.

    Conclusions:

    • Pudendal neuralgia is a significant contributor to idiopathic vulvodynia.
    • Medical management, including tricyclic antidepressants and antiepileptic agents, can be effective.
    • Increased awareness of pudendal neuralgia will improve diagnosis and patient care for chronic vulvar burning.