PUDENDAL NEURALGIA (AKA THE MOST IMPORTANT CAUSE OF PELVIC PAIN THAT YOU HAVE NEVER HEARD OF)

Why this resource is helpful:

"I learn a lot from my patients. Sometimes, more than I would like to admit.

Yes, we doctors may disparage our patients who consult Dr. Google before seeing us and there is a lot of misinformation out there. But sometimes we are reminded that most of our medical education happens long after medical school or even residency.

Five years ago, I had a 30-something patient who presented with intense vulvar pain. She explained to me that she had rough (consensual) sex a month prior and ever since then, she had a burning sensation. She had done her research online and concluded that this might be Pudendal Neuralgia. I nodded knowingly, implying that of course I had heard of this, being a board-certified gynecologist. While I left the room to have her undress, I quickly ran to my laptop to google 'What the heck is Pudendal Neuralgia?'

Her exam confirmed that pressure on her pudendal nerve reproduced her pain, I gave her a prescription for Amitriptyline and had her follow-up with me a month later. Had I been more experienced with this disorder, I would have also referred her for Pelvic Floor therapy. Fortunately, the medication worked and her symptoms slowly resolved.

What is Pudendal Neuralgia (PN)? PN is a nerve pain caused by damage, inflammation or entrapment of the Pudendal Nerve. In women, this supplies innervation to the vulva, perineum and lower buttocks. It travels through a small space deep in the pelvis called 'Alcock's Canal,' named after Dr. Benjamin Alcock, an Irish anatomist in the early 1800s who dissected a lot of pelvises."

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