Therapeutic pudendal nerve blocks using corticosteroids cure pelvic pain after failure of sacral neuromodulation.

A patient with bladder frequency and urgency associated with pelvic pain had no control of symptoms by previous bladder distention, hysterectomy, or sacral nerve root stimulator. A clinical and neurophysiological diagnosis of pudendal neuropathy was made. Treatment with a nerve protection program and pudendal nerve perineural injections of local anesthetics and corticosteroids has provided total symptomatic relief that is durable.