Nantes criteria for pudendal neuralgia by pudendal nerve entrapment

Essential criteria
  • Pain in the pudendal nerve area from the anus to the penis or clitoris

  • Pain is predominantly experienced while sitting

  • Pain does not wake the patient at night

  • Pain with no objective sensory impairment

  • Pain is relieved by diagnostic pudendal nerve block

Complementary diagnostic criteria
  • Burning, shooting, stabbing pain, numbness

  • Allodynia or hyperalgesia

  • Rectal or vaginal foreign body sensation

  • Worsening of pain during the day

  • Predominantly unilateral pain

  • Pain is triggered by defecation

  • Presence of exquisite tenderness on palpation of the ischial spine

  • Clinical neurophysiology findings in men or nulliparous women

Exclusion criteria
  • Exclusively coccygeal, gluteal, pubic, or hypogastric pain

  • Pruritus

  • Exclusively paroxysmal pain

  • Imaging abnormalities able to account for the pain

Associated signs not excluding the diagnosis
  • Buttock pain on sitting

  • Referred sciatic pain

  • Pain referred to the medial aspect of the thigh

  • Suprapubic pain

  • Urinary frequency and/or pain on a full bladder

  • Pain occurring after ejaculation

  • Dyspareunia and/or pain after sexual intercourse

  • Erectile dysfunction

  • Normal clinical neurophysiology

  • Reprinted with permission from John Wiley & Sons. From Labat JJ, Riant T, Robert R, Amarenco G, Lefaucheur JP, Rigaud J. Diagnostic criteria for pudendal neuralgia by pudendal nerve entrapment (Nantes criteria). Neurourol Urodyn 2008; 27(4):306–310. doi:10.1002/nau.20505.2