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
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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
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Exclusion criteria
Exclusively coccygeal, gluteal, pubic, or hypogastric pain Pruritus Exclusively paroxysmal pain Imaging abnormalities able to account for the pain
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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
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