Who Is the Specialist for Pudendal Neuralgia Diagnosis?

The diagnosis and treatment of pudendal nerve neuropathy require a multidisciplinary team. Let’s review the key professionals.

Diagnosis of Pudendal Neuropathy

The diagnosis is essentially clinical, based on:

• Detailed symptom evaluation (pain, burning, shocks, heaviness)
• Exclusion of other causes with targeted tests

Involved Specialists

1. Urologist

   Specialist in urinary and male genital systems, involved when urinary symptoms or genital pain are present.

2. Neurologist

   Assesses nerve function with neurophysiological tests to confirm neuropathy.

3. Gynecologist

   Essential for women with vulvar or vaginal pain; rules out other gynecological conditions.

4. Pain Specialist

   Manages chronic pain with specific medications (tricyclics, antiepileptics, analgesics).

5. Proctologist

   Investigates rectal or anal pain and excludes colon and rectum pathologies.

6. Physiatrist

   Develops pelvic floor rehabilitation programs, including manual and osteopathic techniques.

Treatment Options for Pudendal Neuropathy

• Pharmacotherapy: amitriptyline, gabapentin, pregabalin
• Physical Therapy: muscle relaxation, targeted physiotherapy
• Anesthetic Injections: temporary relief with local injections
• Surgery: decompression in rare refractory cases
• Osteopathy: specific manipulations to release myofascial tensions

Conclusion

A multidisciplinary approach is essential for accurate diagnosis and effective treatment of pudendal neuralgia.

Bibliography

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8. Jensen TS, et al. The clinical picture of neuropathic pain.
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