Objectives: To investigate the efficacy and safety of an improved ultrasound-guided pulsed radiofrequency (PRF) and
nerve block (NB) for patients with
pudendal neuralgia (PN). Methods: This retrospective analysis included 88 adults with PN treated in the
Pain Department of Southwest Hospital from November 2011 to June 2021, with treatment including NB (n = 40) and PRF (n = 48). The primary outcome variable was
pain severity, measured by a standardized visual analog scale (VAS). VAS values were collected at 1, 3, 7, and 14 days and 1 and 3 months after patients were treated with NB or PRF. Results: Compared with patients treated with NB (n = 40) and those treated with PRF (n = 48), no significant difference in
pain reduction was observed in the short term (p = 0.739 and 0.981, at 1 and 3 days, respectively); however, in the medium and long term (1 to 3 months), there were statistically significant improvements in the PRF group over the NB group (p < 0.001). Moreover, it was noted that the average
pain severity of primary PN and PN due to sacral
perineurial cyst was significantly reduced with PRF
therapy in the medium and long term when compared to other secondary PNs, including surgery,
trauma, and diabetes. Discussion: The ultrasound-guided, improved, and innovative PRF/NB
puncture path technique allows for gentler stimulation and faster identification of the pudendal nerve. The PRF technique may provide better treatments for primary PN and sacral
perineurial cyst causing secondary PN in the medium and long term.