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There is no one cause of pudendal neuralgia. It may be related to: 1  Childbirth trauma. 2  Gynaecological or colo-rectal surgery. 3  Cycling. 4  Excessive physical exercise. 5  Past pelvic or perineal trauma. 6  Injury. 7  Straining.
Pudendal Neuralgia. The pudendal nerve is the main nerve of the perineum. The perineum is the area between the testicles and anus of a man, and the vagina and anus of a woman. When this nerve suffers an injury, it can result in the most chronic and disabling form of pelvic pain, pudendal neuralgia.[1].udendal Neuralgia. The pudendal nerve is the main nerve of the perineum. The perineum is the area between the testicles and anus of a man, and the vagina and anus of a woman. When this nerve suffers an injury, it can result in the most chronic and disabling form of pelvic pain, pudendal neuralgia.[1].