Anatomy-Physiotherapy-logo

  • Italiano (Italia)
  • Français (France)
  • Portuguese (PT)
  • Deutsch (Deutschland)
  • Spanish (ES)
  • English (UK)
New english website, click here ->

           

  • Articles
    Evidence based articles
    • Musculoskeletal
      • Upper extremity
      • Lower extremity
      • Spine
    • Other
      • Nervous
      • Circulatory
      • Nutrition
      • Aging
      • Pain
      • Various
  • Art & Design
    Anatomy related art
  • Videos
    Webinars & more
  • Create account
    Personal pages & favourites
  • Login
    Login to A&P
Anatomy-Physiotherapy-logo
17 Oct2016

17 October 2016.

Written by Eric Walper
Posted in Pelvis

17-10-2016 06:28:14
whria
Image by: whria

Anatomical variations of the pudendal nerve

Pudendal neuralgia is an uncommon yet highly impactful condition of the pelvis and lumbar plexus that results in uncharacteristic symptoms and pain in the perineal and pelvic region. Damage can result from a variety of mechanisms including: stretch, compression or entrapment and is often assessed as a precipitating factor of pelvic floor pain in pre- and postnatal patients. To date, there has been poor characterization of the pudendal nerve (PN) and its surrounding tissues. Therefore, the authors undertook an extensive cadaveric dissection to shed light on the anatomical variations between patients. Overall, the authors discovered that there was significant variation of the number of PN trunks, as well as inclusion of the inferior rectal nerve (IRN) within the pudendal canal. Furthermore, there appeared to be a consistent fixation of the pudendal canal on the sacrospinous ligament (SSL), which could have significant clinical implications.

The PN is formed from the contributions of the second, third and fourth sacral nerves and provides both the motor and sensory distribution to the perineal region of the pelvis. Once formed, the nerve exits the pelvis through the greater sciatic foramen and travels on the posterolateral surface of the sacrospinous ligament, entering the perineum through the lesser sciatic foramen and coursing through the pudendal canal to its final divisions.

Detailed dissections using a transabdominal and perineal approach were carried out in thirteen unembalmed female cadavers (61-95 y/o). Measurements (diameter and length) were taken of both the pudendal nerve and inferior rectal nerve. Their association with the pudendal canal and sacrospinous ligament was also characterized.

Following dissection, it was shown that the PN was consistently formed from the contributions of the second, third and fourth sacral nerve roots. After coalescence, 61.5% of PN’s were found to have a single nerve trunk that entered the pudendal canal. The IRN entered the pudendal canal with the PN only 42.3% of the time. Surprisingly, it was revealed that the pudendal canal was consistently attached to the dorsal aspect of the SSL. The authors note that this could in turn result in an over-estimation of nerve entrapment as this is a conserved difference. While the concept of anatomical variation is not new, its existence helps shed light on possible factors involved in complex and non-responding populations.

> From: Maldonado et al., Am J Obstet Gynecol 213 (2016) 727(Epub ahead of print). All rights reserved to Elsevier Inc. Click here for the Pubmed summary.

authors
Image by: authors

Please log in or create an account to place comments. It's free and takes only a minute.

About the Author
Eric Walper
Eric Walper
Eric Walper works as a Musculoskeletal Physical Therapist in Canada. He holds a Bachelors degree in Human Immunity and a Masters degree in Physical Th...

Latest articles from this auhtor

  • Gender differences in gait kinematics in runners with ITBS
  • Real time visualization of joint cavitation
  • Squat exercise and hip extensor strategy
  • Resting foot posture and its effects on gait kinematics
  • Foam rolling, a literature review
 

 

Login

  • Forgot your password?
  • Forgot your username?
  • Create an account
AP banner Sono 1

Related

Sub Menu

  • Musculoskeletal
    • Upper extremity
      • Shoulder
      • Elbow
      • Wrist
      • Hand
    • Lower extremity
      • Hip
      • Knee
      • Ankle
      • Foot
    • Spine
      • Pelvis
      • Lumbar
      • Thoracic
      • Rib cage
      • Cervical
  • Other
    • Nervous
    • Circulatory
    • Nutrition
    • Aging
    • Pain
    • Various

Newsletter

Subscribe to our weekly newsletter to receive all articles of the week in your mailbox.

 

Partners

enraf nonius

apa

fontys

vpt

kiné care

ICMSU

  • Home
  • About
  • Team
  • Advertise
  • Contact
  • Terms of Service
  • Privacy Policy
  • Jobs
  • Newsletter archive
AP-SMALL-WHITECopyright 2010 - 2021 Anatomy & Physiotherapy. All Rights Reserved.

Privacy Policy

AdBlock detected

We want to keep offering top-notch content for free. In order to keep up with the additional costs that we incurr with scaling our website, we need your help! Please turn off your adblocker or consider donating a small amount.

http://www.anatomy-physiotherapy.com/donate

Close
You can also just close this popup. It shows only once.
isApp.it
  • Articles
    Evidence based articles
    • Musculoskeletal
      • Upper extremity
        • Shoulder
        • Elbow
        • Wrist
        • Hand
      • Lower extremity
        • Hip
        • Knee
        • Ankle
        • Foot
      • Spine
        • Pelvis
        • Lumbar
        • Thoracic
        • Rib cage
        • Cervical
    • Other
      • Nervous
      • Circulatory
      • Nutrition
      • Aging
      • Pain
      • Various
  • Art & Design
    Anatomy related art
  • Videos
    Webinars & more
  • Create account
    Personal pages & favourites
  • Login
    Login to A&P
You are now being logged in using your Facebook credentials