What this specialty covers.

Pudendal neuralgia is a painful perineal condition that usually appears from the age of forty onwards, mainly in women — roughly two cases out of three. It does not spare younger patients, and is seen from the thirties.

The pudendal nerve is a sensory, motor and autonomic nerve. It leaves the spinal cord at its lowest part and governs the perineum. Its course includes an unavoidable passage: it runs along the lesser pelvis, passes between the sacrospinous and sacrotuberous ligaments, then enters a fibrous canal, Alcock's canal. It then gives three branches — the perineal nerve, the dorsal nerve of the penis or clitoris, and the inferior rectal nerve. It is along this course that the nerve can be compressed; the branches arising from it then suffer, as do the organs and muscles they supply.

The condition remains poorly known among doctors. Patients go through test after test, all normal, and are often told the pain is psychological: hence the long diagnostic wandering and the delay in treatment. Medic Interface Maroc takes these files for what they are — real pain, a diagnosis made from the history and the clinical examination, and treatments whose effectiveness varies a great deal from one method to another.

Reasons for referral

Your situation is not on this list? It is not exhaustive: send your file and a doctor will read it.

Tests and treatments

specialist consultation and focused history
clinical examination reproducing the pain on vaginal or rectal examination
ultrasound- or CT-guided diagnostic block of the pudendal nerve
pelvic MRI to rule out another cause
perineal electromyography where indicated
medical treatment for neuropathic pain, tailored to each case
pudendal nerve injections
physiotherapy and pelvic floor rehabilitation
surgical decompression by the transgluteal route
surgical decompression by laparoscopy, less invasive

The technique used depends on your file. It is settled by the doctor at consultation and stated in your proposal before you travel.

Four steps, from your file to your return.

01

Send us your file

First step: understanding your situation

02

Receive your assessment

A proposal suited to your situation

03

We organise your stay

Your stay, shaped around your needs

04

We stay with you until you are home

Support on the ground, and after your stay

What we organise around the medical care.

You take only what you need: nothing is imposed and nothing is sold as a package.

Medical appointments

Consultations, tests and surgery placed in an order that makes sense, with no day lost between two appointments.

Visa support

Letter of medical care and supporting documents, for the nationalities that require them.

Accommodation and transfers

A place to stay near the facility, airport pick-up and travel during your stay.

Travelling companion

We plan for them from the start: accommodation, transfers and presence at consultations.

What patients ask us.

It is perineal pain caused by compression of the pudendal nerve along its course, between the sacrospinous and sacrotuberous ligaments and then within Alcock's canal. The pain runs from the pubis to the anus, worsens when sitting and eases when lying down. It often takes the form of burning, electric shocks or heaviness, with a sensation of a foreign body in the vagina or rectum.

Because the diagnosis is chiefly clinical: no test shows the compression. Normal results therefore do not mean the pain is imagined. What points to it is the rhythm of the pain and the clinical examination, which reproduces the pain exactly on vaginal or rectal examination.

It is an injection of an anaesthetic, with or without a corticosteroid, guided by ultrasound or — better — by CT, at the point where the nerve passes. The result is immediate: if the pain subsides, the diagnosis is confirmed. It is the strongest evidence available.

Several approaches are offered — physiotherapy, chiropractic, radiofrequency, cryoneurolysis — but their effect is usually transient, close to a placebo effect. The two genuinely effective routes are properly conducted medical treatment tailored to each case, and surgical decompression of the nerve, by the transgluteal route or by laparoscopy, which is less invasive. The choice is made at consultation, once the diagnosis is confirmed.

Have your file read before you decide.

A doctor reviews it and tells you what is possible, what is not and what it involves. With no commitment on your part.

In the same category

The information on this page is general and does not replace a consultation. No indication, timescale or outcome can be established without a doctor reading your file.

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