Diagnostic and therapeutic algorithm for pudendal nerve entrapment syndrome

Abstract

Pudendal nerve entrapment syndrome is widely unknown and often misdiagnosed or confused with other pelvic floor diseases. The aim is to develop a diagnostic and therapeutic algorithm based on a review of the existing literature. For its diagnosis, an anamnesis will be carried out in search of possible aetiologies, surgical history, and history of pain, assessing location and irradiation, intensity on the visual analogue scale, timing, triggering factors and rule out alarm signs. A physical examination will be performed, looking for trigger points or areas of fibrosis with transvaginal / transrectal palpation of the terminal branches of the nerve. With a doubtful diagnosis, an anaesthetic block of the pudendal nerve can be performed. Once the diagnosis is confirmed, the treatment will begin staggered with lifestyle changes, drug therapy and physiotherapy. In view of the failure of these measures, invasive therapies such as botulinum toxin injection, pulsed radiofrequency and decompression surgery or spinal cord stimulation will be used.

Keywords: Chronic pelvic pain; Descompresión del nervio pudendo.; Disfunción del suelo pélvico; Dolor pélvico crónico; Lesión del nervio pudendo; Neuralgia del nervio pudendo; Pelvic floor dysfunction; Pudendal nerve decompression.; Pudendal nerve entrapment syndrome; Pudendal nerve injury; Pudendal neuralgia; Síndrome de atrapamiento del nervio pudendo.