Pudendal block in treating pudendal neuralgia caused by pudendal nerve entrapment: indications, techniques, interpretation

摘要

abstract_textpPudendal blocks are essential in the diagnosis of pudendal neuralgia resulting from nerve compression. When there is clinical suspicion of the disorder, a positive diagnostic block is crucial in confirming the diagnosis, while a negative result, when the technique is performed correctly, will exclude the diagnosis. This article addresses how to interpret test results, the criteria for positive and negative results, and the various techniques used. We suggest image-guided (scanner) infiltration, with the injection of a contrast agent to follow the diffusion of the anaesthetic. First, an infiltration is performed into the ischial spine (sacrospinatus ligament), then into Alcock's canal (splitting of the aponeurosis of the obturator internus muscle). The diagnostic block also plays a therapeutic role because it confirms the origin of the pain and contributes to the therapeutic alliance. It also opens the way for the therapeutic injection of corticosteroids, although their effectiveness has not been investigated./p/abstract_text