Robotic Pudendal Nerve Decompression
Precise, minimally invasive relief for pudendal neuralgia — even in areas beyond the reach of traditional surgery.
What is pudendal nerve entrapment? Pudendal nerve entrapment occurs when the pudendal nerve is compressed along its course — most often within Alcock’s canal or at the sacrospinous and sacrotuberous ligaments. In many patients, the compression is driven by inflammation, fibrosis, or deep infiltrating endometriosis on the pelvic sidewall.
Symptoms – Burning, sharp, or electric pain in the perineum – Pain with sitting — the classic hallmark – Pain radiating to the vagina, rectum, or clitoris – Painful intercourse (dyspareunia) – Urinary urgency or frequency – Bowel dysfunction or painful defecation
Why it’s often missed — and why traditional treatments fall short Physical therapy, medications, and nerve blocks can help some patients, but they don’t release deep intrapelvic compression. Traditional transgluteal or transperineal surgery works from outside the pelvis: visualization is limited, wide dissection through the gluteal muscles is required, and key ligaments such as the sacrotuberous ligament may need to be cut and reconstructed. Most importantly, the underlying cause inside the pelvis often goes untreated.
How ESSI treats it Our surgeons use a robotic intrapelvic approach with direct, high-definition visualization of the pudendal nerve and the entire lumbosacral plexus. This allows precise decompression, release of Alcock’s canal and surrounding adhesions, excision of any endometriosis driving the compression, and treatment of adjacent nerves when needed — all through small incisions.
What to expect – Minimally invasive robotic procedure – Typically outpatient or short hospital stay – Duration depends on complexity – Decompression is achieved immediately at surgery
Recovery — Nerve healing is gradual: early improvement within weeks, continued recovery over several months. Medications, neuromodulation, or targeted radiofrequency may support healing.
Recovery — Nerve healing is gradual: early
improvement within weeks, continued recovery over several months. Medications,
neuromodulation, or targeted radiofrequency may support healing.