Pudendal neuralgia, a painful condition of the genital, buttock or pelvic area, is most commonly caused by pudendal nerve entrapment, according to the International Pudendal Neuropathy Association. People may develop pudendal nerve entrapment following surgery or may have a pudendal nerve that is more prone to injury because of how it travels in the body. Certain movements, sports, prolonged sitting or other causes of pressure on the pudendal nerve can also cause pudendal neuralgia.
Pudendal Nerve Entrapment
Pudendal nerve entrapment can occur in different sections of the nerve's path, through the bony pelvis and surrounding muscles and ligaments, as described by Dr. Aaron Filler in the February 2009 issue of "Neurosurgical Focus." The patients described in Filler's case series commonly reported symptoms starting after a pulled muscle in their pelvic region, local trauma or bicycle riding. Dr. Kobi Stav and colleagues also describe pudendal nerve entrapment after surgery for vaginal prolapse in the March 2009 issue of "Obstetrical and Gynecological Surgery." During surgery to repair relaxation of the vaginal wall, a ligature to tie can inadvertently be placed around the pudendal nerve.
Nerve Compression
Compression of the pudendal nerve caused by growth of a tumor or endometriosis may lead to pudendal neuralgia. Bicycling and prolonged sitting are other potential causes of pudendal nerve compression.
Nerve Damage
The pudendal nerve may be directly damaged by trauma to the bony pelvis. Other causes of nerve damage, according to Stav and colleagues, include infection from herpes virus, radiation to the pelvic area for cancer treatment and injury to the nerve during a nerve block.
Stretching of the Pudendal Nerve
Some people may develop pudendal neuralgia after the nerve has been stretched. Stretching can occur with chronic constipation, during childbirth or with traction of the legs during surgery.
References
- "Neurosurgical Focus"; Diagnosis and Treatment of Pudendal Nerve Entrapment; Aaron Filler, MD; February 2009
- "Obstetrical and Gynecological Surgery"; Pudendal Neuralgia Fact or Fiction?; Kobi Stav, MD, Peter Dwyer MB, BS, Franzcog and Les Roberts, MD; March 2009
- International Pudendal Neuropathy Association
