Recalcitrant Pelvic Pain: Evaluating the Effectiveness of Pulsed Radiofrequency Ablation for Pudendal Neuropathy Management

Pudendal neuropathy is a complex and often treatment-resistant cause of chronic pelvic pain. This study evaluated the efficacy of CT-guided pulsed radiofrequency ablation (pRFA) compared to traditional perineural steroid injections in patients with refractory pudendal neuralgia. Using a retrospective cross-sectional design, 49 patients were assessed for pain relief duration, quality of life, and analgesic use over six months. The average pain relief duration following pRFA was 9.48 ± 9.52 weeks, significantly longer than that of the first (3.98 ± 3.56 weeks) and most recent steroid in-jections (3.32 ± 3.21 weeks; p < 0.0001 for both). Quality of life scores improved significantly through three months post-procedure, and analgesic use decreased during this time. No significant correlation was found between symptom duration and treatment effectiveness. These findings suggest that pRFA provides longer-lasting pain relief and improved outcomes, supporting its role as a minimally invasive and effective treatment option for managing chronic pudendal neuropathy.