What Is Pudendal Neuralgia?
Pudendal neuralgia is a chronic and often misunderstood condition caused by irritation or entrapment of the pudendal nerve — one of the main sensory and motor nerves in the pelvic region. This nerve travels from the lower spine, through the pelvis, and innervates the perineum, genitals, and anus.
When compressed or inflamed, it can trigger intense pain and disrupt daily life — often without a clear diagnosis.
Common Symptoms:
Patients often describe symptoms such as:
✔ Burning, stabbing, or electric-shock pain in the pelvic region
✔ Pain while sitting, which eases when standing or lying down
✔ Numbness, tingling, or pins-and-needles sensations
✔ Pain during or after sexual activity
✔ A foreign body sensation in the rectum or vagina
✔ Increased discomfort throughout the day
✔ Urinary or bowel urgency without infection
These symptoms may appear gradually and fluctuate — making diagnosis challenging.
Causes and Risk Factors
Pudendal neuralgia can be caused by:
✔ Prolonged sitting (e.g. office work, truck driving, cycling)
✔ Childbirth and pelvic trauma
✔ Pelvic surgeries (e.g. prolapse repairs, hysterectomy)
✔ Scar tissue or fibrosis
✔ Anatomical compression (e.g. in Alcock’s canal or between ligaments)
✔ Sports injuries or chronic strain
In many patients, the underlying cause is multifactorial — combining nerve entrapment with musculoskeletal dysfunction.
How Is Pudendal Neuralgia Diagnosed?
Pudendal neuralgia is a clinical diagnosis based on symptoms, physical examination, and exclusion of other causes.
We use internationally recognized Nantes Criteria to assess:
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Pain in the pudendal nerve territory
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Increased pain while sitting
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No waking pain at night
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No objective sensory loss
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Temporary relief after pudendal nerve block
Advanced diagnostics may include:
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Pelvic MRI neurography
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Ultrasound-guided nerve blocks
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Electromyography (EMG) for nerve function
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Functional pelvic floor assessment
Conditions That Mimic Pudendal Neuralgia
Many patients are misdiagnosed with:
✔ Chronic prostatitis
✔ Interstitial cystitis (IC)
✔ Endometriosis
✔ Vulvodynia
✔ Coccydynia (tailbone pain)
✔ Sciatica
✔ Piriformis syndrome
That’s why a specialist team with experience in pelvic nerve pathology is essential for accurate diagnosis and treatment.
Treatment Options for Pudendal Neuralgia
Conservative Treatments
For mild to moderate cases, we often start with:
✔ Neuropathic pain medication (e.g. amitriptyline, gabapentin)
✔ Pelvic floor physical therapy
✔ Trigger point release & nerve gliding techniques
✔ Postural correction
✔ Ultrasound-guided nerve blocks
These treatments may reduce nerve irritation and break the pain cycle.
Surgical Treatment — When Conservative Care Isn’t Enough
If symptoms persist after 6–12 months, surgery may be indicated.
Pudendal nerve decompression is a microsurgical procedure that releases pressure from anatomical structures compressing the nerve — such as ligaments or fibrosis.
Our clinic specializes in:
✔ Open and laparoscopic decompression
✔ Image-guided planning (MRI neurography)
✔ Minimally invasive techniques
✔ Surgical outcomes tracking
What Is Pudendal Nerve Decompression Surgery?
Pudendal nerve decompression is the definitive treatment when conservative care fails. During this procedure, the nerve is released from entrapment, improving blood flow and reducing inflammation.
We operate under magnification using nerve-sparing techniques to maximize safety and outcomes.
Ideal candidates:
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Have had symptoms for 6+ months
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Have positive findings on imaging or nerve blocks
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Have failed physical therapy and medications
Surgical outcomes:
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70–80% report significant long-term relief
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Low complication rate in experienced hands
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Full return to sitting, intimacy, and active life is possible
Frequently Asked Questions (FAQ)
What is pudendal neuralgia?
A nerve pain caused by irritation of the pudendal nerve, resulting in chronic pain in the pelvic area.
What causes it?
Compression or injury to the nerve – often from cycling, childbirth, pelvic surgery, or prolonged sitting.
What does it feel like?
Burning, stabbing, or sharp pain in the pelvic or genital area.
How do I know if I have it?
If sitting worsens your pain and no other cause has been found – pudendal neuralgia could be the reason.
Can you sit with pudendal neuralgia?
Often very difficult. Some people use specialized cushions.
Can it be treated?
Yes – with physical therapy, nerve blocks, or surgery.
Is it dangerous?
Not life-threatening – but it can severely affect your quality of life.
How is it diagnosed?
Through a thorough evaluation of symptoms, clinical exams, and sometimes nerve blocks.
What conditions can be confused with pudendal neuralgia?
Prostatitis, interstitial cystitis, endometriosis, piriformis syndrome.
Where should I turn for help?
To a specialized clinic like ours – we offer the full diagnostic and treatment process under one roof.
What to Expect – Your Journey Step by Step
We know how overwhelming it can feel to search for answers when you’re in pain. At Pudendal Surgery, we guide you through every step – from first contact to full recovery.
Our process is personal, precise, and proven. You’ll meet specialists who take your symptoms seriously and offer real solutions tailored to your needs. No guesswork. No unnecessary delays. Just clear steps toward healing.
1. Book a free consultation:
Online or in-person – you’ll speak directly with a specialist.
2. We listen and map your symptoms:
No symptom is “too strange” – we’ve heard it all before.
3. You get a personalized diagnostic plan:
This may include MRI, ultrasound, or a diagnostic nerve block.
4. We confirm whether it’s pudendal neuralgia:
We rule out other causes and provide clear answers.
5. You receive a tailored treatment plan:
Conservative therapy first – surgery only if needed.
6. Surgery by a world-leading expert:
We perform pudendal nerve decompression using advanced microsurgical techniques.
7. Ongoing support – you’re never alone:
We follow you through every step of recovery.
Physical therapy
Physical therapy sessions to strengthen pelvic muscles and ensure proper nerve function.
Guide
Guidelines on gradually resuming activities.
Follow-up
Regular follow-up appointments to monitor recovery and address any concerns.
Why Choose Us?
Our clinics in Dubai and Belgium specialize in pudendal nerve surgery, ensuring top-quality care with exceptional results. We prioritize your health with personalized treatment plans and state-of-the-art technology for a swift and successful recovery.
Over 600+ successful pudendal surgeries
One of the few global centers specialized in this condition
Treatment available in Belgium & Dubai
Multilingual care team (EN, SE, FR, DE, AR)
Led by Dr. Renaud Bollens, internationally recognized surgeon
Fast-track consultation — no referral required
Ready to Find Out If You’re a Candidate?
Pudendal neuralgia is real. And it’s treatable.
Take the first step by speaking to someone who understands what you’re going through.