Research, pioneered by Dr. Stanley Antolak, supports a link between interstitial cystitis (IC) and pudendal neuralgia (PN), a painful nerve inflammation. Pudendal neuralgia can sometimes look similar to IC when there is no IC, or IC and pudendal neuralgia can exist at the same time in a patient.

Overlapping symptoms include pelvic pain, sexual dysfunction, and difficulty with urination. PN patients may also have difficulty with defecation and a feeling that a foreign object may be in the body. Pain, typically in the perineal, rectal, and the clitoral areas in women and in the penis in men, may be less severe early in the day and may subside when the patient lies down or stands up.

Also referred to as “cyclist’s syndrome,” “pudendal canal syndrome,” or “Alcock’s syndrome,” PN can be triggered by bicycling, squatting exercise, or direct falls on the tailbone. Triggers also include repeated vaginal infections and chronic constipation, as well as secondary trauma due to childbirth, surgery, and bio-mechanical abnormalities (e.g., sacro-iliac joint dysfunction or pelvic floor dysfunction).

As in IC, diagnosis is made through a process of ruling out other conditions. Many patients find that nerve blocks completely relieve their symptoms. Dr. Antolak, who launched the PN and IC overlap research during his practice at a major clinic in Rochester, Minnesota, is now part of the MAPS Pain Clinic in Edina, Minnesota.

For the latest information on pudendal neuralgia, please visit the Society for Pudendal Neuralgia (SPuN) website.

Revised Wednesday, March 25th, 2015