One of the most common causes of genital and pelvic pain, "Pudendal Nerve Compression", also known as "Pudendal Neuropathy", is the problem of one out of every 15 people in our country. However, due to the difficulty of diagnosis and the fact that many physicians are not familiar with the subject, patients may have to live with difficulties for years without being diagnosed. Thanks to the new diagnostic method developed by Yeditepe Koşuyolu Hospital Neurology Specialist, a much faster and more accurate diagnosis can be made. Thus, it is possible to get treatment without wasting time.

A problem similar to wrist nerve compression, known in society as carpal tunnel syndrome, can also occur in the pudendal nerve, which is responsible for the genital area. This problem, which is manifested by problems such as pain in the genital area, especially with sitting, sexual function problems, and urinary or fecal incontinence, is often confused with urinary tract infections or prostatitis. Therefore, patients may have to continue living with pain despite the antibiotic treatment they have received for months. It is extremely important to make a timely diagnosis because pudendal nerve compression can cause physical problems as well as consequences that can lead the person to the point of isolation from society.

Pain During Sexual Intercourse Is Among Recognizing Supportive Symptoms…

This problem, which occurs especially in women who give birth a lot, can start suddenly due to reasons such as heavy lifting, reverse movement, falling, or heavy sports activity, or it can occur gradually over time. Our specialist, who says that the most prominent feature of pudendal nerve compression is the feeling of pain experienced by the patient while sitting, gives the following information about the problems experienced by the patient:

“Pain from pudendal compression is usually seen near the nerve. Patients talk about annoying feelings in the vagina and rectum. However, pain during bowel movements is complained of at an unbearable level due to pressure, especially when urinating, when constipated. While it is less felt in the morning, it is described as stinging such as increasing pain during the day, burning, tearing, electrification, and a sharp knife. It is not accompanied by itching or loss of sensation. It is necessary to suspect the existence of a different problem in such a picture. Also, if not in every patient, pain in the hip while sitting, pain that spreads to the sciatic nerve region and does not respond to treatment, frequent urination, especially in women, and pain during sexual intercourse are among the recognizable supportive symptoms. ”

Patients with pudendal nerve compression are also unable to perform simple everyday activities, such as driving a car or cycling. In short, since the quality of life of patients is impaired, they have difficulty doing the activities required by daily life.

Cannot be Detected by Imaging Methods

Different methods are used for the diagnosis of pudendal nerve compression, from laboratory findings to imaging. However, since the underlying cause cannot be found most of the time, considering that the source of the problem is psychological, the patient can be directed to receive treatment in this direction. Stating that it is very difficult to perform electrical diagnostic methods (such as EMG, SEP) since the nerve passes deeply, our expert gives the following information: “The pudendal nerve is located on both the right and left side of the genital area, but neuropathic pain is usually seen on one side or more on one side. In the examinations performed so far, since the evaluations were always made in such a way that two nerves were evaluated at the same time in the middle line, the nerve that was not problematic or less problematic could not be diagnosed as it covered the findings of the problematic nerve. In addition, although the pain was caused by sitting, in the past, the examinations were always performed in bed. This prevented the problem from being identified.”

Diagnostic Method Accepted by International Authorities

Stating that they started to evaluate the two nerves separately with the newly developed electrical diagnostic method, our expert continues as follows: “We have further developed the existing method. We were able to evaluate the two nerves separately with the small electrodes we placed on the right and left. Thus, we were able to detect whether there was a compression in the unilateral or bilateral pudendal nerve. In addition, we were able to shoot not only while lying down, but also in the sitting position where the pain was most severe. In this way, diagnoses that could not be made for 3-4 years in the past can now be made faster. This method, which we apply as a standard diagnostic method, has also been accepted by international authorities. “

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