A Pudendal Nerve block is a procedure using x-ray or ultrasound guidance to treat symptoms of genital, tailbone (coccyx), and/or rectal pain (pudendal neuralgia) by blocking the nerve impulses. Injecting the area around the pudendal nerve with a local anesthetic (lidocaine) and steroid will give immediate temporary relief of genital, rectal, and/or tailbone (coccyx) pain.
Repeating the injections can eliminate or substantially reduce the pain in many patients. In some cases, a more permanent block can be considered. This is performed using a radiofrequency ablation process.
What conditions are treated with Pudendal Nerve Blocks?
A pudendal nerve block is mainly used to treat the condition characterized by symptoms of genital and/or rectal pain (pudendal neuralgia) caused from pudendal nerve entrapment as it passes through the pelvic region. It can also become inflamed through local trauma such as a stretch injury, but often the reason for the inflammation is due to obesity, tight clothing, weight gain, or pregnancy. Patients with diabetes are more susceptible to this condition.
How is the procedure performed?
Our team will help position you to make sure the procedure can be completed with the least amount of discomfort for you. The skin is cleansed with a sterilizing solution (chlorhexidine) and a sterile drape is placed. A local anesthetic medication typically (Lidocaine) is given to numb the skin. Next, fluoroscopy (x-ray) or ultrasound is used to find the target. A thin needle is directed to the desired location. A local anesthetic and/or steroids are then injected. During the entire procedure you will be constantly monitored by our team. After the injection a small bandage is placed on your skin. You will be given time after the procedure to make sure you feel good and are not having side-effects before leaving the clinic.
What medication is injected?
The injection includes a combination of anesthetic (lidocaine or bupivacaine) and steroid (cortisone, Kenalog or dexamethasone). The local anesthetic will be responsible for the immediate relief and the steroid is used to provide more long-term relief.
Does the procedure hurt?
The procedure is typically well tolerated. A localized burning sensation from the anesthetic is commonly felt and is usually the most uncomfortable part of the process. During the procedure a pressure sensation is often experienced this typically resolves within a few minutes. Minor soreness for a week after the procedure is normal.
How long does the procedure take?
The procedure typically takes about 15 minutes to perform. Please plan on being at the clinic for about 1 hour to allow for pre and post-procedural safety protocols.
How quickly will I get relief?
It can take up to a week for the steroid medicine to reduce pain and inflammation. Our team will follow-up with you and determine the need for any future injections.
How long can I expect the relief to last?
Every patient is different. Most patients get reduced pain lasting 2-4 months. Some patients can get relief lasting greater than a year.
How often can the procedure be repeated?
Depending on results and providers discretion the injections may be repeated up to 3-4 times per year for sustained pain relief.
Will the steroid injection result in more health problems long term?
There is minimal absorption from steroid injections to other areas of the body. For this reason, many of the side effects that occur with systemic steroid usage do not occur with local steroid injections. The systemic side effects of weight gain, osteoporosis (thin bones), and increased blood pressure typically do not occur with steroid injections.
Can I have the injection if I have diabetes?
Yes. It is important to control your blood sugar before and after the injection. Diabetic patients may experience a temporary increase in blood sugar which should resolve in a few days after the procedure.
What are the risks and side effects?
Risks and side effects are minimal and serious complications are rare. We take every precaution to ensure safety. Potential risks may include but are not limited to: vasovagal response (passing out), new or increased pain, infection, bleeding, permanent skin changes, allergic or unexpected drug reaction with minor or major consequences, and unintended nerve injury.