Pudendal Nerve Block

The pudendal nerve carries sensation from the perineum and contributes to pelvic floor function. Pudendal nerve irritation can cause persistent pelvic, perineal or genital pain, sometimes described as burning, shooting or electric-shock-like. A pudendal nerve block may be considered when the clinical pattern suggests pudendal neuralgia or another pudendal nerve pain syndrome.

Using X-ray or ultrasound guidance, a fine needle is positioned near the pudendal nerve, usually in the region where the nerve passes close to the ischial spine or within the pudendal canal. A small amount of local anaesthetic, sometimes with corticosteroid, is injected around the nerve. Image guidance helps improve precision and reduce the risk of affecting nearby structures.

The response to the block can provide useful diagnostic information and may provide temporary relief of pelvic pain. If the benefit is clear but short-lived, pulsed radiofrequency may be considered in selected patients. Dr Danesh will interpret the response alongside your symptoms, examination and other investigations rather than relying on the block alone.