A novel technique for pudendal nerve block

Pudendal nerve block is performed to confirm the diagnosis of pudendal neuralgia. Many physicians and patients are hesitant to pursue diagnostic nerve blocks to confirm the diagnosis of pudendal neuralgia secondary to significant patient discomfort, the need for special equipment, and the risk in the traditionally described approach. Objective: To describe a novel technique for pudendal nerve block with minimal risk and decreased patient discomfort. Description of the Technique: With the patient in the prone position, the C-arm is projected in the anteroposterior position until the pelvic inlet is visualized. Subsequently, the ischial spine is highlighted by 5 to 15 degree ipsilateral oblique angulation of the fluoroscope. A 25-gauge 3.5 cm needle is advanced to the tip of the ischial spine where the pudendal nerve transiently leaves the pelvis. The pudendal nerve block is performed at this level. Conclusion: We described a new and novel technique to block pudendal nerve under fluoroscopic visualization safely with increased patient comfort.