Chronic pelvic pain syndrome
ICD-10 R10.2 · ICD-11 MG30.00

Chronic Pelvic Pain Syndrome with Neuropathic Perineal Pain in the Pudendal Nerve Distribution

This protocol addresses patients with chronic pelvic pain syndrome presenting with neuropathic perineal pain localised to the distribution area of the pudendal nerve, where there is evidence of underlying nerve injury.

The perineal pain in this scenario follows the distribution of the pudendal nerve and is attributable to nerve damage — a presentation distinct from primary perineal pain syndrome. This form of nerve-injury-associated perineal pain, sometimes referred to as pudendal neuralgia, is the most commonly described type of pudendal nerve damage in the clinical literature. Accurate characterisation of the nerve injury is central to guiding intervention.

Management involves a targeted interventional approach directed at the site of pudendal nerve injury or entrapment, using image-guided or nerve-stimulator-assisted localisation. The complete regimen — including the full procedural sequence, agent selection, and referral pathway — is detailed in the structured protocol.

References

  1. Primary perineal pain syndrome should be distinguished from pudendal neuralgia, which is a specific disease associated with perineal pain that is caused by nerve damage.
  2. In the literature, pudendal neuralgia is the most often mentioned form of nerve damage.
  3. An injection of local anaesthetic and steroid at the sight of nerve injury or nerve entrapment may produce a therapeutic action.
  4. The anatomical target may be localised by fluoroscopy, computed tomography (CT) guidance, or the use of US.
  5. If a peripheral nerve pain syndrome is suspected, refer early to an expert in the field, working within a multidisciplinary team environment.
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