Pudendal neuralgia (pudendal nerve entrapment, Alcock syndrome) is a condition of chronic neuropathic pain consistent with the pudendal nerve dermatome. Pain is typically intense and sharp and occasionally described as numb. Pain may appear in the perineum, rectum, vulva, vagina, clitoris, scrotum, and/or the glans penis. Pain can affect the entire area or it may be localized to a branch of the pudendal nerve.

Findings include dysuria, dyschezia, dyspareunia, and erectile dysfunction. Pain typically increases while sitting and does not classically wake patients from sleep. Etiology includes nerve compression or entrapment (caused by surgery, childbirth, or trauma), herpes simplex, pressure from tumors, endometriosis, chemoradiotherapy, and exercises such as biking or squatting. Pudendal neuralgia occurs much more frequently in women than in men.

Initial treatment includes physical therapy, muscle relaxants, and neuromodulators. Pudendal nerve block is used for both diagnostic and therapeutic purposes.