Pudendal Nerve

Description

Posterior view of pelvis demonstrating the pudendal neurovascular bundle. The gluteus maximus muscle was cut to show the deeper structures. The pudendal nerve and artery run in the interligamentous plane between the sacrospinous and sacro-tuberous ligament and subsequently into Alcock’s canal.

Anatomy of the Pudendal Nerve and its branches

Illustration showing the normal pelvic course of the pudendal nerve and its branches

Name

• Pudendal Nerve

General

• One of the major somatic nerves of the sacral plexus
• Nerve Roots: S2-S4
• Innervates the external genitalia of both sexes, skin of the anus, anal canal and perineum
• Muscles of the pelvis

Anatomic Course

• Forms from the ventral rami of S2-S4 of the sacral plexus
• Descends between piriformis, ischiococcygeus
• Leaves the pelvis through the greater sciatic foramen
• Crosses the sacrospinous ligament, re-enters pelvis via the lesser sciatic foramen
• After re-entering the pelvis, it accompanies the pudendal artery/vein
• Courses anterosuperior through pudendal canal
• There it divides into branches

Sensory

• Inferior rectal nerve
  • Perianal skin and lower third of the anal canal
• Perineal nerve
  • Skin of the perineum
  • Labia minora and majora or posterior scrotum.
• Dorsal nerve of the penis or clitoris
  • Skin of the penis or clitoris
  • Responsible for the afferent component of penile and clitoral erection.

Motor

• Bulbospongiosus
• Ischiocavernosus
• Levator Ani
• External Urethral Sphincter

---

Clinical Significance

• Pudendal Neuralgia
• Pudendal Nerve Block

---

See Also

• Neuropathies Main
• Groin Pain Main
• Physical Exam Groin

---