The pudendal nerve is the nerve in males that is responsible for carrying sensations from the penis, the rectum, and the perineum (the area between the anus and the genitals) to the brain. If the nerve is damaged, or affected by neuropathy (the medical term for disease and damage to the any nerve), symptoms occur in the genital or groin area. In women, the pudendal nerve is also responsible for carrying sensations in the genital area to the brain.
Causes of Pudendal Nerve Damage
Pudendal nerve pain can occur as a result of a number of different factors. Sudden trauma from an accident or injury, such as from a fall or a bike accident, may stretch or put pressure on the pudendal nerve, causing nerve damage. Trauma or injury could also cause fibrosis, a condition which results in the pinching of the pudendal nerve. Other potential causes include childbirth, pelvic surgery, diabetes, multiple sclerosis, or severe constipation. Finally, if the pelvic muscles are strained over a long period of time, for example by regular bike riding or aggressive weightlifting, pudendal nerve pain can occur from this sustained trauma.
The majority of patients with pudendal nerve damage report rectal pain, which may or may not be accompanied by difficulty emptying the bowels. However, some patients report pain primarily focused in the genitals or the perineum. The pain varies by patient; it may be stabbing pain, throbbing pain, burning pin, a twisting feeling, a tingly pins and needles type feeling, a numbness in the area, or hypersensitivity in the area. Typically, the symptoms worsen when you sit and are relieved when you either stand or lay down.
Pudendal nerve damage is generally first suspected as a result of revealing symptoms to a physician. The doctor usually then injects a local anesthetic into the area containing the nerve, which is most likely causing the pain. If the pain stops after the injection, then the nerves in the area where the injection was given are the damaged nerves.
According to Pudendal.com, nerve blockers to help stop the pain may be administered, but the pin relief from this treatment method is normally temporary. Steroids or botox injections to the affected nerves may provide permanent relief, but this treatment method only works in a minority of patients.
Surgery is often the most successful method for treating pudendal nerve pain, and is successful between 60 and 70 per cent of the time. There are 3 different approaches to surgery: the transperineal approach, which opens the Alcock's canal by making an incision between the anus and ischial bone, the transgluteal approach, which makes the incision in the buttocks, and the transvaginal approach (for women), in which case the nerve is accessed through the vagina. The purpose of all three methods of surgery is to relieve the pressure on the pudendal nerve.