A vast range of expert online resources. Pudendal neuralgia was first described in by Amarenco et al. Still, this syndrome if often unrecognized by the majority of physicians, including physicians experienced in pelvic pain such as gynecologists, urologists, and neurologists.
Spinosa et al. Orphanet, www. Pudendal neuralgia is described as a neuropathic pain in the distribution of the pudendal nerve. Pain may be localized to the clitoris, labia, vagina, and vulva in women, and to the penis and scrotum in men, excluding testes. In both sexes, pain may be localized to the perineum, rectum, and area immediately medial and anterior to ischial tuberosities.
Symptoms are frequently unilateral, however, in patients presenting with bilateral pain, there is often a more affected side. Neuropathic pain is described as a burning, tingling, or itching sensation.
A small percentage of patients may have pain outside the area of innervation for the pudendal nerve, commonly presenting in the lower abdomen, posterior thigh, and lower back. This pain is usually attributed to muscle spasm or somatic referred pain. Innervation of perineum. Typically, symptoms are present with sitting and absent during standing or lying down. However, with disease progression, the pain may become constant and severely aggravated by sitting.
Most patients tolerate sitting for only several minutes before their pain becomes unbearable, and some are unable to sit at all. Interestingly, most patients report absence or improvement of pain when sitting on a toilet seat, 6 as the body weight in this position is supported by the ischial tuberosities, thereby relieving pressure from the pelvic floor.
