One of the most common causes of genital and pelvic pain, “Pudendal Nerve Jam”, also known as “Pudendal Neuropathy,” is one of every 15 people in our country. However, due to the difficulty of the diagnosis and the fact that many physicians are not familiar with the subject, patients may have to live without problems for years. Thanks to the new diagnostic method developed by Burcu Örmeci – Yeditepe Koşuyolu Hospital Neurology Specialist Assoc. Dr. diagnosis can be made much faster and more accurately. Thus, it is possible to switch to treatment without wasting time.
A problem similar to wrist nerve compression, known in the community as carpal tunnel syndrome, can occur in the Pudendal nerve, which is responsible for the genital area. This problem, which manifests itself with problems such as pain, sexual function problems, urination or incontinence, especially with sitting in the genital area, is often confused with urinary tract infections or prostate inflammation. Therefore, patients may have to continue living with pain, despite the antibiotic treatment they have received for months. Pudendal nerve compression is very important to make a timely diagnosis as it can have physical problems as well as consequences that can take the person from the society to the point of abstraction.
Pain During Sexual Intercourse is Among the Recognitive Supporting Findings…
This problem, which occurs especially in women giving birth, may start suddenly due to reasons such as heavy lifting, reverse movement, falling or a heavy sports activity, and it may also appear gradually over time. Stating that the most prominent feature of pudendal nerve compression is the pain sensation experienced by the patient while sitting. Dr. Burcu Örmeci gives the following information about the problems experienced by the patient:
“Pains caused by pudendal compression are usually seen near the nerve. Patients talk about the feeling of alienation in the vagina and rectum. However, pain during bowel movements is complain of unbearable pain due to pressure, especially when constipated when urinating. While it is felt less in the morning hours, the pain that increases during the day is described as stinging like burning, tearing, electrifying, sharp knife. It is not accompanied by itching or loss of sensation. It is necessary
to suspect that there is a different problem in such a table. Also, though not in every patient, the feeling of pain in the hip while sitting, pain that spreads to the sciatic nerve area and does not respond to treatment, frequent urination, pain during sexual intercourse, especially in women, are among the supporting supportive findings. ”
Patients with pudendal nerve compression cannot perform simple daily activities such as driving or cycling. In short, as the quality of life of the patients deteriorates, they have difficulty in doing the activities required by daily life.
Cannot be Detected by Imaging Methods
Different methods from laboratory findings to imaging are used for the diagnosis of pudendal nerve compression. However, since the underlying cause is not found most of the time, the patient can be directed to receive treatment in this direction, considering that the source of the problem is psychological. Saying that it is very difficult to perform electrical diagnostic methods (such as EMG, SEP) as the nerve passes deeply. Dr. Burcu Örmeci gives the following information: “The pudendal nerve is located both to the right and left of the genital area, but neuropathic pain is generally seen on one side or more on one side. Since the evaluations have been carried out so as to evaluate both midline and two nerves at the same time, no problem or less problematic nerve covers the findings of the problem nerve, so the diagnosis could not be made. In addition, although pain occurred with sitting, examinations were always inpatient. This prevented the problem from being detected. ”
Diagnosis Method Also Accepted Internationally
Explaining that they started to evaluate two nerves separately with the electrical diagnosis method they developed, Assoc. Dr. Burcu Örmeci continues her words as follows: “We have further developed the existing method. With the small electrodes we placed on the right and left, we managed to evaluate the two nerves separately. Thus, we were able to determine whether there was compression in the unilateral or bilateral Pudendal nerve. We also managed to shoot, not just inpatient, but also in a sitting position where the pain was most severe. Thanks to this, diagnoses that could not be made for 3-4 years in the past can now be made faster. This method, which we use as a standard diagnostic method, was also accepted by international authorities. “