Pudendal Nerve Block: Uses, Procedure and Side Effects
Updated: 2 days ago
Written and medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: November 2026 · How we review
Quick Answer
A pudendal nerve block is an injection of numbing medicine near the pudendal nerve in the pelvis, which supplies the genital and anal area. It's used to diagnose and treat chronic pelvic pain from pudendal neuralgia and as regional anesthesia for childbirth. Relief can last days to years, though about 20% of blocks don't work.
What the research says
It reduced opioid use after hemorrhoid surgery: in 14 randomized trials with 1,214 hemorrhoidectomy patients, a pudendal block lowered the need for opioids, reduced pain at 24 hours, shortened hospital stays and cut readmissions (Mongelli F et al., Diseases of the Colon and Rectum, 2021) [2]
Treatments for pudendal neuralgia lowered pain: across 37 studies of injections, surgery and pulsed radiofrequency for pudendal neuralgia, all approaches lowered pain by an average of 2.73 cm on a 10 cm pain scale, with no treatment clearly better (Andiman SE et al., International Urogynecology Journal, 2025) [3]
Key takeaways
A pudendal nerve block numbs the nerve that supplies the genital and anal area.
It helps diagnose and treat chronic pelvic pain.
It's also used as anesthesia for childbirth and some surgeries.
Numbing can start within an hour.
Not every block works.
What is a pudendal nerve block?
The pudendal nerve supplies the muscles and skin of the genital and anal area. Damage to it can cause pudendal neuralgia and chronic pelvic pain. A block is a type of nerve block. Sources: [1]
Why it's done
It can reduce the need for general anesthesia and opioids.
Purpose | How it helps |
Diagnosis | Pain relief suggests the pudendal nerve is the cause |
Treatment | Eases chronic pelvic pain from pudendal neuralgia |
Anesthesia | Numbs the area for labor, vaginal repairs or hemorrhoidectomy |
As anesthesia, it can be safer than general anesthesia and reduce the need for opioids. Sources: [1, 2]
Types of approaches
The block can be done on one or both sides.
Approach | How it's done |
Transvaginal | Through the vagina, often with a needle guide |
Transperineal | Through the skin between the genitals and anus |
Perirectal | Near the rectum, sometimes with a nerve stimulator |
Fluoroscopic-guided | X-ray guided while lying face down; most common for pudendal neuralgia |
Sources: [1]
How to prepare
Usually no special preparation is needed. If you'll get sedation, you may need to fast for 6 to 8 hours and have someone drive you home. Sources: [1]
What happens during the block
Local anesthetic may relieve pain within an hour.
You lie on your back, side or belly, depending on the approach.
The area is cleaned.
Your provider locates the nerve by touch, ultrasound or X-ray.
Numbing medicine, sometimes with a steroid, is injected.
The block may be repeated on the other side. Sources: [1]
Risks
Discomfort at the injection site, usually fading in a couple of days.
Bleeding or infection.
Temporary leg numbness or weakness.
Rarely, nerve damage, bladder or rectum injury, or a dangerous reaction if medicine enters a blood vessel. Sources: [1]
Recovery and results
You rest for 15 to 30 minutes while a nurse watches you.
Local anesthetic may relieve pain within an hour; a steroid may take a couple of days.
Relief may last days, weeks, months or years.
Repeat blocks, often monthly, can help pudendal neuralgia. Sources: [1]
Not everyone responds. About 20% of blocks fail on average, and up to 50% of two-sided blocks may fail on at least one side. Sources: [1, 3]
When to call your provider
Call right away for new symptoms or problems, such as signs of infection, burning pain, tingling or weakness that doesn't go away. Sources: [1]
Conclusion
A pudendal nerve block can pinpoint and ease pelvic pain or numb the area for childbirth and surgery. Results vary, so you and your provider may adjust the plan over time.
Keep learning: read about chronic pelvic pain and nerve blocks.
Frequently asked questions
What is a pudendal nerve block?
An injection that numbs the nerve supplying the genital and anal area.
What is it used for?
Diagnosing and treating pelvic pain, and anesthesia for childbirth and some surgeries.
What is pudendal neuralgia?
Pain from damage to the pudendal nerve.
Does it hurt?
You may feel discomfort at the injection site for a couple of days.
How fast does it work?
Local anesthetic may work within an hour.
How long does relief last?
From days to years, depending on the person.
Does it always work?
No. About 20% of blocks fail on average.
Can it be repeated?
Yes, often monthly or as needed.
Can I go home afterward?
Usually after resting 15 to 30 minutes.
Is it used during labor?
Yes, in the second stage of labor.
Related Reading
Pudendal Nerve: Function, Anatomy, Symptoms and Care the pudendal nerve.
Chronic Pelvic Pain: Symptoms, Causes & Treatment — A Clear Guide causes of pelvic pain.
Understanding Nerve Blocks: A Comprehensive Guide to Targeted Pain Relief an overview of nerve blocks.
Hemorrhoidectomy: Purpose, Procedure, Recovery and Risks a surgery that may use this block.
Interstitial Cystitis: Understanding Bladder Pain Syndrome another pelvic pain condition.
References
Cleveland Clinic. Pudendal Nerve Block: What It Is, Procedure & Side Effects. Cleveland Clinic. Last updated April 19, 2023. https://my.clevelandclinic.org/health/treatments/24917-pudendal-nerve-block
Mongelli F, Treglia G, La Regina D, et al. Pudendal nerve block in hemorrhoid surgery: a systematic review and meta-analysis. Diseases of the Colon and Rectum. 2021;64(5):617-631. PMID 33591044. https://doi.org/10.1097/DCR.0000000000001985
Andiman SE, Maron JS, Dandolu V, et al. Impact of treatment of pudendal neuralgia on pain: a systematic review and meta-analysis. International Urogynecology Journal. 2025;36(1):35-58. PMID 39607531. https://doi.org/10.1007/s00192-024-06004-x
Medical disclaimer
This article is for general education only and does not replace advice from a qualified healthcare professional. Talk to your doctor about your own diagnosis and treatment, and seek emergency care right away for severe or sudden symptoms.
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