Pudendal Nerve Pulsed Radiofrequency Effectively Alleviates Perineal Pain in Interstitial Cystitis/Bladder Pain Syndrome: A Retrospective Study.

OBJECTIVES

Interstitial cystitis/bladder pain syndrome (IC/BPS) is a refractory chronic pelvic pain disorder. In patients presenting with perineal pain, quality of life is severely compromised due to the lack of effective analgesic interventions. This study aimed to evaluate the efficacy and safety of pudendal nerve pulsed radiofrequency (PRF) for managing perineal pain in IC/BPS patients.

METHODS

We conducted a retrospective analysis of 51 female IC/BPS patients who underwent pudendal nerve PRF treatment at Peking University People's Hospital between January 2020 and May 2024. Therapeutic outcomes were evaluated using validated metrics including the visual analog scale (VAS), interstitial cystitis problem index (ICPI) and symptom index (ICSI), hospital anxiety and depression scale (anxiety: HADS-A and depression: HADS-D), and pain catastrophizing scale (PCS) to comprehensively assess treatment efficacy on perineal pain and associated psychosocial comorbidities.

RESULTS

The VAS score decreased from 8.0 (7.0, 9.0) preoperatively to 4.0 (2.0, 6.0) at 6 months postoperatively (p < 0.0001). Both ICPI and ICSI scores decreased from 14.0 (12.0, 15.5) and 15.0 (12.0, 18.0) preoperatively to 8.0 (5.5, 11.0) and 8.0 (6.0, 13.0) at 6 months postoperatively, respectively (p < 0.0001). HADS-A and HADS-D scores decreased from 8.0 (4.5, 12) and 7.0 (4.5, 11.5) preoperatively to 5 (2.5, 9) and 3.0 (1.5, 7.0) at 6 months postoperatively, respectively (p < 0.05). The PCS score decreased from 36.58 ± 10.93 preoperatively to 13.46 ± 6.80 at 6 months postoperatively (p < 0.0001). The outcomes of pudendal nerve diagnostic blocks showed positive correlations with postoperative improvements in VAS, ICPI, and ICSI at 6 months. A small number of patients experienced transient buttock puncture site pain and acute urinary retention postoperatively, all of which resolved spontaneously without serious adverse reactions.

CONCLUSIONS

Pudendal nerve PRF demonstrates significant therapeutic efficacy in managing perineal pain among patients with IC/BPS. The outcomes of pudendal nerve diagnostic blocks exhibit predictive value for the effectiveness of pudendal nerve PRF in alleviating IC/BPS-associated perineal pain.