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Pudendal Neuromodulation as a Treatment for Persistent Genital Arousal Disorder—A Case Series

Gaines, Natalie, MD*; Odom, Brian D., BS; Killinger, Kim A., MSN*†; Peters, Kenneth M., MD*†

Female Pelvic Medicine & Reconstructive Surgery: July/August 2018 - Volume 24 - Issue 4 - p e1–e5
doi: 10.1097/SPV.0000000000000435
Case Series

Background Persistent genital arousal disorder (PGAD) is a rare life-altering condition characterized by unwanted, uncomfortable genital sensations or spontaneous orgasms without physical or emotional stimulation. Its etiology remains unclear, and a variety of treatments have been attempted with incomplete resolution. We propose that chronic pudendal neuromodulation (CPN) may be a useful treatment for PGAD symptoms.

Methods A retrospective chart review was performed for women older than 18 years with a diagnosis of PGAD that had staged neuromodulation with placement of a tined lead at the pudendal nerve. Demographic, operative, and postoperative data were collected. A survey was then sent to these women to assess additional demographic data, preoperative and postoperative symptoms, and patient satisfaction. Descriptive statistics were performed.

Results Six women underwent CPN for PGAD. Mean age was 52 (SD, 9) years. Five (83%) of 6 were still implanted at time of survey, at a mean of 38 months after implantation; 1 device was removed for nonuse. Four of 6 completed surveys and were still using their device. Three of 4 had met their treatment goals and were satisfied with CPN; 3 of 4 felt CPN was the most useful treatment modality they had used overall. Chronic pudendal neuromodulation also improved chronic pelvic pain (4/4), bowel function (3/4), and bladder function (3/4).

Conclusions Chronic pudendal neuromodulation can be an effective treatment for decreasing frequency of PGAD symptoms and providing symptom relief.

From the *Department of Urology, Beaumont Health, Royal Oak; and

Oakland University William Beaumont School of Medicine, Rochester, MI.

Correspondence: Kenneth M. Peters, MD, Department of Urology, Beaumont Health, 3535 West Thirteen Mile Rd, Suite 438, Royal Oak, MI 48073. E-mail:

The authors declare that they have nothing to disclose.

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