The pudendal nerve is the main nerve responsible for all motor and sensory functions of the genital area. It has 3 main branches leading to the anus area, the areas responsible for urination and the genital organs.
Pudendal neuropathy is a disease that occurs as a result of compression and crushing of the pudendal nerve branches in certain areas. The symptoms are complaints related to the loss of function of the relevant nerve branch and pain that usually occurs when sitting and is limited to the genital area. Pain in the lower hip and leg is not an expected situation in pudendal neuropathy. The pain decreases by lying down or standing up. It is not accompanied by itching. Sensory deficits and numbness may occur. Pain that wakes you up at night is not expected. Numbness or loss of strength in the legs cannot be related to the pudendal nerve.
Generally, multiple or difficult births, staying under weight for a long time or doing squats with weights, climbing mountains, falling, cycling, reverse movements, etc. It occurs due to situations such as.
It usually takes many years for patients to be diagnosed with pudendal neuropathy. First, other common causes should be investigated and excluded. In cases where no cause is found, support can be obtained from electrophysiological tests for diagnosis. Pudendal EMG is not an examination performed by every center. Additionally, contrast-enhanced pelvic MRI examinations that visualize the pudendal nerve may also support the diagnosis.
If the pudendal MRI and EMG results are normal, then pudendal neuralgia can be mentioned. Here, although the pudendal nerve does not have any serious problems anatomically, it becomes functionally diseased and begins to create pain sensation.
Neuralgic pain is most commonly seen in the face (trigeminal neuralgia) and neck (occipital neuralgia), but neuralgic pain can potentially occur in any region with sensory nerves. Pudendal neuralgia is treated like other neuralgic pain. However, it should not be forgotten that chronic pain in the genital area will lower the pain tolerance threshold and disrupt psychology. For this reason, pudendal neuralgias should almost always be treated with psychiatric support.
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