Introduction:

Pudendal neuralgia is defined as pain along the dermatome of the pudendal nerve and can occur in both sexes. Being a pathology capable of mimicking many other organic conditions, its diagnosis usually appears after months of symptoms. The present case report aims to emphasize a rare pathology, some of its clinical aspects, and diagnostic criteria, demonstrating an example of how the delay in the diagnosis can lead to excessive spending of health resources as well as to significant physical and psychological suffering.

Case description:

A 73-year-old female patient resorts to a medical appointment in the Family Health Unit in August 2016 for complaints of vulvar burning and discomfort in the suprapubic region with three weeks of evolution. Empirical antibiotic therapy was performed, with no improvement in symptoms. Because of the complaints’ persistence, she resorts to several appointments at the Family Health Unit and various medical specialties in the public and private regime, being medicated with various antibiotics, antifungals, corticosteroids, among others. Several auxiliary diagnostic tests have been carried out and numerous diagnostic hypotheses have been raised until more than a year since the appearance of the first symptoms, the most probable diagnosis of pudendal neuralgia is established. Despite the diagnosis, the patient continued to have poorly controlled pain, having to resort to options of the last resource for the treatment of this pathology.

Comments:

Pudendal neuralgia is a condition whose diagnosis is usually reached long after the patient's symptoms have started, with a lot of associated physical and psychological suffering. For this reason, the case report presented pretends to sensitize the health professional to this diagnosis and to the importance of the family doctor as an integrating element of the patient's care.

        · resumen en Portugués     · texto en Portugués     · Portugués ( pdf )