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摘要

I thank Antolak et al for their thoughtful letter. I, too, believe the pudendal nerve is involved in many of the pain syndromes associated with the interstitial cystitis syndrome. Often in my practice we will perform diagnostic and therapeutic pudendal nerve blocks to help with the pain and elimination syndrome found in these patients. In addition, rather than releasing.the pudendal nerve through an invasive procedure, we have had success in modulating the pudendal nerve by modifying the sacral neuromodulation system (InterStim?) and placing the electrode at the pudendal nerve.1"3 We can significantly improve the care of our patients with pelvic pain, urinary frequency, fecal dysfunction and sexual dysfunction if we introduce a curriculum for clinicians regarding how to assess pain triggers with a focus on the nerves and muscles that contribute to these difficult to treat syndromes.