Pudendal Nerve Block for Postherpetic Pudendal Neuralgia Pain

Pudendal neuralgia is known to disproportionately affect women, with clinical manifestations that may result in a debilitating chronic pain syndrome. The mainstay of treatment is physical therapy, pharmacologic treatment, or interventional procedures for refractory pain. In regard to pudendal neuralgia secondary to herpes simplex infection, only one previous published case report was found, indicating the need for future development of treatment regimens.

The patient is a 28-year-old woman with a past medical history of herpes simplex virus infection, after which she developed residual vulvar sensitivity refractory to conservative treatment and pharmacologic intervention. A pudendal nerve block was performed, resulting in significant pain relief post intervention.

The utilization of a pudendal nerve block with local anesthetic and dexamethasone provided an overall reduction of her baseline vulvar pain not previously achieved by prior treatment. Pudendal nerve blocks may serve an important role in the treatment of refractory postherpetic neuralgia pain.