Conventional Versus High-Voltage Long-Duration Pulsed Radiofrequency of the Pudendal Nerve
Comparing Conventional and High-Voltage Long-Duration Pulsed Radiofrequency Applied to the Pudendal Nerve in the Treatment of Pudendal Neuralgia: A Randomized Controlled Trial
Ankara City Hospital Bilkent
38 participants
Feb 19, 2025
INTERVENTIONAL
Conditions
Summary
This study is a single-center, prospective, randomized controlled trial evaluating two types of pulsed radiofrequency (PRF) treatment for patients with pudendal neuralgia. Pudendal neuralgia is a chronic neuropathic pain affecting the perineum and pelvic area, often causing significant discomfort and reduced quality of life. Patients will be randomly assigned to receive either conventional PRF or high-voltage long-duration PRF applied to the pudendal nerve. The study aims to compare the clinical effectiveness, pain relief, and safety of the two treatment approaches. Participants will be monitored for pain improvement, functional outcomes, and any treatment-related side effects. The study follows standard clinical procedures and all treatments are performed under sterile conditions with proper monitoring to ensure patient safety.
Eligibility
Inclusion Criteria7
- Adults aged 18 years or older
- Diagnosis of pudendal neuralgia according to the Nantes diagnostic criteria
- Followed at the Algology (Pain Medicine) outpatient clinic
- Chronic pudendal neuralgia refractory to conservative treatment or intolerance to conservative therapies
- Not using neuropathic pain medications, or on a stable dose for at least 3 months prior to enrollment
- Ability to comply with study procedures and follow-up visits
- Ability to understand the study information and provide written informed consent
Exclusion Criteria11
- Presence of pelvic organic pathologies that may cause pudendal pain
- Pain limited only to the coccygeal, gluteal, or lower abdominal regions
- Patients with purely paroxysmal pain, isolated pruritus, or imaging findings that fully explain symptoms
- History of malignancy or autoimmune disease
- Previous surgery that may have altered the anatomy of the pudendal nerve region
- Pregnancy or suspected pregnancy
- Presence of a cardiac pacemaker or implanted electrical device
- Use of anticoagulant therapy or presence of uncorrectable coagulation disorders
- Active systemic infection or infection at the injection site
- Known hypersensitivity to metals
- Inability or unwillingness to provide informed consent
Interventions
Conventional pulsed radiofrequency (PRF) is applied to the pudendal nerve at 42°C for 360 seconds, with a pulse frequency of 2 Hz and pulse width of 20 ms. The procedure is performed under sterile conditions in the operating room with patient monitoring (blood pressure, pulse, ECG, oxygen saturation). Patients are positioned prone, the target site is sterilized, and the PRF needle is placed under fluoroscopic guidance. Bilateral symptoms are treated sequentially if present.
High-voltage long-duration pulsed radiofrequency (PRF) is applied to the pudendal nerve at 42°C for 900 seconds, with a pulse frequency of 2 Hz and pulse width of 20 ms. The voltage is titrated from 40V to a patient-tolerated maximum of 90V. The procedure is performed under sterile conditions in the operating room with patient monitoring (blood pressure, pulse, ECG, oxygen saturation). Patients are positioned prone, the target site is sterilized, and the PRF needle is placed under fluoroscopic guidance. Bilateral symptoms are treated sequentially if present.
Locations(1)
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NCT07356102