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Background: Persistent genital arousal disorder (PGAD) is a condition characterized by unwanted and potentially painful genital sensations or spontaneous orgasms without stimulation. We present a case of a 55‐year‐old woman with refractory genital arousal disorder that was treated with serial pudendal nerve blocks. Case: RW is a 55‐year‐old woman with chronic pelvic pain, pudendal neuralgia, MDD, SI, GAD, CRPS, and persistent genital arousal disorder for 11 years. Her PGAD was refractory to conservative management, physical therapy, and bilateral clitoral artery embolization. We performed bilateral pudendal nerve blocks with Kenalog and Bupivacaine, which provided almost complete relief for 2–3 months. We performed a bilateral pudendal nerve radiofrequency ablation; however, there was minimal benefit. RW continues to have significant relief with serial pudendal nerve blocks. Summary and Conclusion: Persistent genital arousal disorder is often refractory to medication and physical therapy requiring significant intervention such as entrapment surgery or artery embolization. Our case demonstrates pudendal nerve blocks as a potential treatment modality with minimal side effects. [ABSTRACT FROM AUTHOR]

Restless genital syndrome (RGS) is a rare disorder marked by paresthesia and discomfort in the genital area, akin to restless legs syndrome (RLS). While RLS typically affects the lower limbs, its impact on areas such as the bladder has been noted. RGS individuals exhibit sensory symptoms akin to RLS, including difficulty expressing sensations and a compulsion for genital rubbing. Thus, RGS is viewed as an atypical RLS presentation, characterized by genital sensory symptoms. Despite the rarity, this report details a successfully managed case using conventional RLS treatments. Numerous RGS aspects need clarification, including prevalence and treatment. Due to its distressing nature, sustained investigation is vital. Though lacking a standard treatment, our patient benefited from traditional RLS medication, hinting at shared mechanisms. Further research is vital for understanding and treating RGS effectively., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Ari et al.)