Imiportance of PN block before trying surgery

[Violet M]

https://pubmed.ncbi.nlm.nih.gov/26999519/

This article confirms the importance of having a positive pudendal nerve block (CT guided) containing an anesthetic prior to trying PNE surgery. It specifically says anesthetic, which would mean something like marcaine. (It does not address steroid injections which some major medical organizations have concluded have no benefit.) So my interpretation is that basically, if you have immediate relief for a short period of time right after a nerve block, your chances of having a successful surgery are higher than if you don't get any immediate short-term relief. It was a small sample of patients (only 28) but what's interesting is that 100% of the patients (6) who did not have positive nerve blocks also did not have successful surgeries.

[Violet M]

I should add that sometimes nerve blocks miss the pudendal nerve and there can be some physician error involved, so you could potentially still have pudendal nerve entrapment that would respond to surgery, even if you did not have any temporary pain relief after a nerve block. This article explains it well: https://www.ncbi.nlm.nih.gov/sites/books/NBK544272/