Conventional Versus High-Voltage Long-Duration Pulsed Radiofrequency of the Pudendal Nerve

Ankara City Hospital

Status: Enrolling

Conditions: Pudendal Neuralgia

Treatments: Procedure: Intervention Type * Select the type of intervention. Procedure / Surgery Intervention Name * Enter a brief, descriptive name for the intervention. Use a non-proprietary (generic) name, if available; Procedure: High-Voltage Long-Duration Pulsed Radiofrequency

Study type: Interventional

Funder types: Other

Identifiers

NCT07356102

E2-25-10056

Details and patient eligibility

About

This study is a single-center, prospective, randomized controlled trial evaluating two types of pulsed radiofrequency (PRF) treatment for patients with pudendal neuralgia. Pudendal neuralgia is a chronic neuropathic pain affecting the perineum and pelvic area, often causing significant discomfort and reduced quality of life.

Patients will be randomly assigned to receive either conventional PRF or high-voltage long-duration PRF applied to the pudendal nerve. The study aims to compare the clinical effectiveness, pain relief, and safety of the two treatment approaches. Participants will be monitored for pain improvement, functional outcomes, and any treatment-related side effects.

The study follows standard clinical procedures and all treatments are performed under sterile conditions with proper monitoring to ensure patient safety.

Full description

This single-center, prospective, randomized controlled trial aims to compare the clinical effectiveness and safety of conventional pulsed radiofrequency (PRF) versus high-voltage long-duration PRF applied to the pudendal nerve in patients with pudendal neuralgia.

Eligible patients will be randomly assigned to one of the two intervention groups. Conventional PRF will be applied at 42°C for 360 seconds, while high-voltage long-duration PRF will be applied at 42°C for up to 900 seconds, with voltage titrated from 40V to a patient-tolerated maximum of 90V. All procedures are performed under sterile conditions in an operating room with patient monitoring (blood pressure, pulse, ECG, and oxygen saturation).

Patients will be assessed for pain intensity, functional improvement, and adverse effects at scheduled follow-up visits. Bilateral symptoms will be treated sequentially if present. The study adheres to standard clinical safety procedures and no additional risk beyond routine clinical care is anticipated.

Enrollment: 38 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria

• Adults aged 18 years or older
• Diagnosis of pudendal neuralgia according to the Nantes diagnostic criteria
• Followed at the Algology (Pain Medicine) outpatient clinic
• Chronic pudendal neuralgia refractory to conservative treatment or intolerance to conservative therapies
• Not using neuropathic pain medications, or on a stable dose for at least 3 months prior to enrollment
• Ability to comply with study procedures and follow-up visits
• Ability to understand the study information and provide written informed consent

Exclusion Criteria

• Presence of pelvic organic pathologies that may cause pudendal pain
• Pain limited only to the coccygeal, gluteal, or lower abdominal regions
• Patients with purely paroxysmal pain, isolated pruritus, or imaging findings that fully explain symptoms
• History of malignancy or autoimmune disease
• Previous surgery that may have altered the anatomy of the pudendal nerve region
• Pregnancy or suspected pregnancy
• Presence of a cardiac pacemaker or implanted electrical device
• Use of anticoagulant therapy or presence of uncorrectable coagulation disorders
• Active systemic infection or infection at the injection site
• Known hypersensitivity to metals
• Inability or unwillingness to provide informed consent

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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38 participants in 2 patient groups

Arm 1 - Conventional PRF

Experimental group

Description:

Conventional Pulsed Radiofrequency Description: Conventional PRF applied to the pudendal nerve at 42°C for 360 seconds, 2 Hz, 20 ms pulse width. Standard clinical procedure under sterile conditions.

Treatment:

Procedure: Intervention Type * Select the type of intervention. Procedure / Surgery Intervention Name * Enter a brief, descriptive name for the intervention. Use a non-proprietary (generic) name, if available

Arm 2 - High-Voltage Long-Duration PRF

Experimental group

Description:

High-Voltage Long-Duration Pulsed Radiofrequency Description: High-voltage, long-duration PRF applied to the pudendal nerve at 42°C for 900 seconds, voltage titrated from 40V to patient-tolerated maximum of 90V. Procedure performed under sterile conditions.

Treatment:

Procedure: High-Voltage Long-Duration Pulsed Radiofrequency