The Dellon Institute has surgery for pudendal neuralgia but they don't really have any good way to diagnose. I suppose if you already have diagnosis, that would help. Germany has an institute to deal with pelvic problems under Dr. Posson, but it is Germany so may be difficult to try them. Pain management doesn't always treat this, but some pm docs will do injection and maybe RFA. RFA can cause nerve damage so it is not always best step according to peripheral nerve specialists that do the surgical release. However, surgery has a lot of risks unless surgeon has done a lot of these releases. I don't believe pelvic floor therapy makes much difference, but that is another safer option. Using special cushions with the center line where perineum sits cut out of foam is helpful and cheapest treatment.