Pudendal nerve block by transgluteal way guided by computed tomography in a woman with refractory pudendal neuralgia expressed like chronic perineal and pelvic pain.

OBJECTIVE: To demonstrate that the deep infiltration of the pudendal nerve guided by tomography is a good treatment option for patients with refractory neuralgia.
METHOD: Two cases of pudendal neuralgia are presented, both expressed mainly with pain in the perineal and gluteal areas. Both cases had changes in the skin and one with urinary symptoms. A deep trans-gluteal infiltration guided by CT scan was performed, administering bupivacaine 0.25% with 80 mg methylprednisolone.
RESULTS: In women, after infiltration, there was a decrease in pain from 6 to 3. In man infiltrations were performed monthly, completing 4. He reported pain reduction from 8 to 2.
CONCLUSIONS: Pudendal Neuralgia diagnosis is unknown. The most common cause is inflammation of adjacent structures to the nerve frequently caused by falling. Diagnosis is mainly clinical. Trans-gluteal infiltration guided by CT scan is an effective option in treatment.