Sexual dysfunction due to pudendal neuralgia: a systematic review.

Abstract

Background\nThe pudendal nerve is considered as the main nerve of sexuality. Pudendal neuralgia is an underdiagnosed disease in clinical practice. The aim of this systematic review is to highlight the role of pudendal neuralgia on sexual dysfunction in both sexes.\n\n\nMethods\nA PubMed search was performed using the following keywords: Pudendal AND Sexual dysfunction or Erectile dysfunction or Ejaculation or Persistent sexual arousal or Dyspareunia or Vulvodynia . The search involved patients having sexual dysfunction due to pudendal neuralgia. Treatment received was also reported.\n\n\nResults\nFive case series, seven cohort studies, two pilot studies, and three randomized clinical trials were included in this systematic review. Pudendal nerve and/or artery entrapment, or pudendal neuralgia, is a reversible cause of multiple sexual dysfunctions. Interventions such as anesthetic injections, neurolysis, and decompression are reported as potential treatment modalities. There are no studies describing the role of pudendal canal syndrome in the pathophysiology or treatment of delayed ejaculation or penile shortening.\n\n\nDiscussion\nPudendal neuralgia is an underestimated yet important cause of persistent genital arousal, erectile dysfunction (ED), premature ejaculation (PE), ejaculation pain, and vulvodynia. Physicians should be aware of this entity and examine the pudendal canal in such patients before concluding an idiopathic cause of sexual dysfunction.