Medical treatment of pudendal neuralgia

Pudendal neuralgias are now well defined by clear diagnostic criteria. Their treatment is chiefly surgical if they do not succumb to local anesthesic blocks (infiltrations). Other means are available and often necessary: physiotherapy, a biopsychosocial approach, TENS, drugs. The place of drugs often seems practically obligatory, is poorly known and seldom totally successful. Drugs are only part of the treatment strategy in this pathology and can only be envisaged as part of a pre-defined therapeutic strategy. As with other kinds of neuropathic pain, the drug treatments which we can offer are in most cases tramadol, antidepressants and anticonvulsants. The paucity of randomized controlled trials in this field, the sometimes disappointing therapeutic results of using drugs and the non-negligeable side effects, the disabling effect of this pathology, all mean that an effective multidisciplinary approach is required.