Can pudendal neuralgia be cured?

The female vulva is a very private area, and its blood vessels and nerves are densely distributed. Although pudendal neuralgia is relatively rare, it does not mean that it does not exist. Clinically, it manifests as paresthesia in the genitals, incontinence, sexual dysfunction, weakened or absent anal reflex, tingling and itching, etc. Its occurrence generally involves the sciatic nerve and blood vessels and nerves in the pelvic area. You can adopt traditional Chinese medicine's closed treatment or Western medicine's surgical treatment.

The pudendal nerve comes from the pudendal plexus, and its nerve fibers are composed of the anterior branches of the sacral nerves 2, 3, and 4, which contain many parasympathetic nerve fibers. It runs along with the internal pudendal artery, leaves the pelvis at the lower edge of the piriformis muscle, then bypasses the back of the ischial spine and returns to the pelvic cavity through the lesser sciatic foramen, and passes through the pudendal canal along the outer wall of the ischioanal fossa below the levator ani muscle to reach the perineum. It gives off the following branches in the sciatic rectal fossa: perineal nerve (superficial and deep branches), inferior rectal nerve, and dorsal nerve of the penis (clitoris). It is rare clinically, and patients may experience symptoms such as numbness, tingling, and itching in the nerve distribution area.

Clinical manifestations

1. Paresthesia

Symptoms such as dullness, tingling, and itching appear in the nerve distribution area, and in severe cases, the sensation disappears completely. During the physical examination, symptoms such as hyperesthesia of the genitals were found.

2. Incontinence

It affects the sphincter function and causes symptoms such as incontinence, difficulty urinating or tenesmus.

3. Decreased sexual function

It is the main symptom, and men may suffer from impotence in severe cases.

4. Anal reflex

weaken or disappear.

diagnosis

1. Comprehensive examination to determine whether the disease is caused by spinal canal lesions, sacral lesions, pressure objects below the pelvis, or damage to the nerve trunk itself.

2. It is often accompanied by symptoms such as low back pain, paravertebral tenderness and percussion pain, positive neck flexion test, and limited lumbar spine movement.

3. Dry symptoms or cluster symptoms appear. The situation in the pelvic cavity can be determined by digital rectal examination or bimanual examination. When Thomas' sign is positive, it indicates a high possibility of iliac lumbar inflammation. If appropriate, an X-ray can be taken after cleansing enema to rule out tumors.

treat

1. Mainly block therapy, physical therapy, acupuncture and symptomatic treatment.

2. Surgical treatment

If the pudendal nerve trunk is clearly compressed, release surgery can be performed to try to remove the compression object. For those with severe itching in the perineum, the pudendal nerve on one side can also be cut (male patients should be cautious as this is generally not used).

3. Treat the cause.