For clinicians
Referring a patient with pelvic nerve pain.
Pudendal neuralgia falls between specialties, which is why the average patient waits years for a diagnosis. This page sets out who to refer, what to send, and what you will receive back.
Who to refer
Consider referral when standard workup has been unrevealing and the pain pattern is neuropathic.
- Perineal, genital or rectal pain for more than three months, worse with sitting
- 'Chronic prostatitis' with negative cultures and no antibiotic response
- Vulvodynia or interstitial cystitis unresponsive to standard therapy
- Persistent pelvic pain after mesh, prolapse, hernia or prostate surgery
- Post-partum pelvic pain persisting beyond twelve months
- Positive or partially positive pudendal nerve block awaiting surgical opinion
- Cyclists with persistent perineal pain off the bike
What to send with the referral
A complete package shortens the pathway considerably and often avoids a repeat visit.
- Symptom history with clear documentation of sitting provocation
- Prior imaging — pelvic MRI and MR neurography if performed
- Urine culture and, in men, prostate assessment results
- Physiotherapy summary and response
- Current medication and previous neuropathic trials with doses
- Details and outcome of any previous nerve blocks
What we do
Every patient is assessed against the Nantes criteria with a dedicated pelvic nerve examination. Where indicated we arrange 3T MR neurography and an image-guided diagnostic pudendal block before any surgical discussion.
Pudendal nerve decompression is offered only to patients whose clinical picture, imaging and block response align. Where they do not, we return a conservative management plan rather than operate.
About the surgeon
Dr Renaud Bollens is a urological surgeon with more than two decades of pelvic nerve surgery experience. He has trained over 140 surgeons internationally in pelvic and nerve-sparing technique and operates in Belgium and Dubai.
How to reach us
Email referrals and imaging to info@pelvicinstitute.co. For urgent clinical discussion, our line is available 24/7 on +44 7451 251532 (WhatsApp welcome). Patients may also book a consultation directly without a referral letter.
Common questions
How do I refer a patient?
Send the patient's clinic summary, relevant imaging (ideally MR neurography or pelvic MRI), urine culture results and any prior block responses to info@pelvicinstitute.co, or ask the patient to book a consultation directly. A formal referral letter is welcome but not required.
Which patients are appropriate to refer?
Patients with pelvic, perineal, genital or rectal pain lasting over three months that is worse when sitting, with negative or unhelpful standard workup, or who have failed pelvic-floor physiotherapy and neuropathic medication. Also refer post-surgical pelvic nerve pain and suspected mesh-related nerve injury.
Do you accept international referrals?
Yes. We see patients from Europe, the GCC and Asia at our Belgium and Dubai locations, and offer remote first assessments for international patients so that travel is only arranged once a plan is agreed.
Will you operate on every referred patient?
No, and that is deliberate. Only patients meeting the Nantes criteria with a convincing response to an image-guided diagnostic block are offered decompression. Others receive a written management plan you can deliver locally.
Do you send feedback to the referring clinician?
Yes. Referring clinicians receive a full assessment letter with diagnosis, reasoning, imaging interpretation, block results and the agreed plan, plus operative and follow-up notes where surgery proceeds.
Speak with a pudendal nerve specialist.
Dr Renaud Bollens leads a specialist practice dedicated to chronic pelvic pain, with centers in Dubai and Belgium.