We need you! See something you could improve? Make an edit and help improve WikSM for everyone.

Pudendal Nerve Injury

From WikiSM
Jump to: navigation, search

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]
  • 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

  1. 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
Authors:
Last edited:
15 January 2022 18:21:49
Categories: