Health Organization for Pudendal Education

eraser wrote: ↑Tue May 05, 2026 1:13 pm I have now been doing some further reading and watching of presentations and apparently only very specialised tests assess c-fibre compression that give arise to pain in entrapment - so I do have some further questions to ask at follow-up.

Interesting....I would be interested to know more about this. Any articles or links you could share on the topic?

Violet M wrote: ↑Wed May 06, 2026 4:38 am

eraser wrote: ↑Tue May 05, 2026 1:13 pm I have now been doing some further reading and watching of presentations and apparently only very specialised tests assess c-fibre compression that give arise to pain in entrapment - so I do have some further questions to ask at follow-up.

Interesting....I would be interested to know more about this. Any articles or links you could share on the topic?

I found some interesting papers prior to posting but I can't seem to find the exact ones again, which is very annoying. My impression is that a lot of the papers that refer to neurophysiological tests tend to not refer to specific tests. I think what I had read was referring to tests other than SSEP though, so I think I initially misinterpreted I'm afraid.

An interesting quote from a recent paper: -

Neurophysiological tests, such as perineal and pelvic floor electroneuromyography, are less commonly used in diagnosis as they do not allow for early diagnosis, cannot exclude a diagnosis, and do not correlate with functionality. Moreover, the procedure is quite painful for patients.

Source: https://doi.org/10.1093/pm/pnae092

I know in Dr Bollens recent youtube talk he refers to light compression causing pain and muscle spasm. Whereas strong compression causes numbness and muscle palsy. For complementary exams, I believe he says that perineal EMG's can be normal despite patients being in pain as they do not measure pain. He did refer to SSEP being better though.

Source: https://youtu.be/QcfT1eD8yv8?si=ZbM2ZY6v-YoblbUR

I wonder whether as this is a functional problem, assuming there has been no objective sensory loss, whether the neurophysiological exams are really that valuable given that they are purely completementary exams.

Thanks, Eraser. I think what you are saying makes a lot of sense.

The Nantes Criteria article says the following about electrophysiological studies:

"Electrophysiological studies (electromyography and nerve
conduction studies) only investigate large motor fibers and may
not detect selective lesions of small sensory fibers."

https://www.pudendalhope.info/wp-conten ... iteria.pdf