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Pudendal Nerve Injury
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Contents
Other Names
- Pudendal Neuralgia
Background
History
Epidemiology
Pathophysiology
Pathoanatomy
- Nerve Roots -S2-S4
- Consists of sensory, motor and autonomic nerve fibers
- Sensory - innervates the external genitalia of both sexes and the skin around the anus, anal canal and perineum
- Motor - innervates various pelvic muscles, the external urethral sphincter and the external anal sphincter.
- Forms at the sacral plexus, descends and passes between the piriformis and ischiococcygeus muscles. Nerve exits the pelvis through the greater sciatic foramen, crosses the sacrospinous ligament and re-enters at the lesser sciatic foramen
Risk Factors
Differential Diagnosis
Clinical Features
- History
- Burning pain in the distribution of the pudendal nerve
- Females - Vulva, vagina, clitoris, perineum, rectum
- Males - Glans penis, scrotum, perineum, rectum
- Commonly report hyperalgesia, allodynia or paresthesias
- May have associated symptoms of urinary frequency, urgency, symptoms of painful bladder and dyspareunia
- Classic presentation is unilateral, however bilateral has been reported
- Pain is worse while sitting, relieved with standing or lying down
- Commonly worse when sitting on chair than on toilet
- This allows descent of levator ani with less compression of nerve
- Patients may report sensation of sitting on an object or foreign body in vagina
- Patients commonly favor sitting on a certain side[1]
- Burning pain in the distribution of the pudendal nerve
- Physical Exam
- Special Tests
Evaluation
Classification
Management
Nonoperative
Operative
Rehab and Return to Play
Rehabilitation
Return to Play
Complications and Prognosis
Prognosis
Complications
See Also
References
- ↑ Khoder W, Hale D. Pudendal neuralgia. Obstet Gynecol Clin North Am. 2014 Sep;41(3):443-52. doi: 10.1016/j.ogc.2014.04.002. Epub 2014 Jul 9. PMID: 25155124.
Created by:
John Kiel on 13 June 2019 09:39:57
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Last edited:
15 January 2022 18:21:49
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