Evidence Checklist: Pudendal Neuralgia

Pudendal nerve terminal motor latency (PNTML) or needle EMG of pelvic floorCritical

Electrodiagnostic testing of pudendal nerve motor latency or needle EMG of bulbocavernosus and external anal sphincter muscles documenting pudendal nerve dysfunction.

Diagnostic pudendal nerve block with documented pain reliefCritical

Records of a diagnostic pudendal nerve block with local anesthetic showing 50% or greater pain relief, confirming the pudendal nerve as the pain source (Nantes criteria).

Nexus opinion linking pudendal neuralgia to service (at least as likely as not)Critical

Medical opinion connecting pudendal neuralgia to in-service perineal trauma, prolonged cycling, pelvic surgery during service, or other service event.

Pelvic MRI neurography

MRI neurography of the pelvis to evaluate the pudendal nerve for entrapment, fibrosis, or compression in Alcock's canal or at the ischial spine.

Treatment records (nerve blocks, neuromodulation, decompression surgery)

Records of serial nerve blocks, spinal cord stimulation, or surgical pudendal nerve decompression with treatment response.

Buddy statement from spouse, family, or fellow service member

A written statement from someone who can describe observable symptoms and how your condition affects daily life.

Personal statement describing symptoms and functional impact

Your own written account of how this condition affects your daily activities, work, and relationships. Describe your worst days.

Completed DBQ Peripheral Nerves ConditionsCritical

VA standardized form capturing sensory deficits and functional limitations in the pudendal nerve distribution.

Service treatment records (STRs)Critical

Military medical records showing in-service treatment, complaints, or injuries related to this condition.