AB044. 96. The role of nerve block as a diagnostic tool in pudendal nerve entrapment

Background: Pudendal nerve entrapment (PNE) is a disabling condition which is notoriously difficult to diagnose and treat. A 5-point Nantes Criteria including a diagnostic pudendal nerve block is widely used to allow identification of patients likely to benefit from the definitive but invasive pudendal nerve release. The aim of this study was to determine the role of pudendal nerve block in diagnosis and management of PNE.

Methods: Retrospective analysis was performed of a prospectively maintained database examining outcomes of recipients of diagnostic pudendal nerve block in a quaternary referral centre over a 5-year period [2012–2017]. Primary outcome was relief of chronic intractable pain. Secondary outcomes were referral patterns for nerve release, demographics and complication rates. Statistical analysis was performed using SPSS v 24.

Results: A total of 77 patients were included. Mean age was 57.27±13.55 years. A majority were female (n=62, 80.5%). Pain was experienced by 47/76 (68.1%). Of 37 patients (52.9%) referred for surgery, 20 underwent surgical decompression with 60% success rate (n=12). Complication rate was 3.9% (All Clavien Dindo 1).

Conclusions: Pudendal nerve injection is a safe procedure that can provide diagnosis of and transient relief from this debilitating problem. This technique helps isolate patients suitable for referral for pudendal nerve decompression.

Keywords: Pudendal nerve entrapment (PNE); injection pudendal nerve entrapment (injection PNE); neuralgia pelvic floor