The nerve comes out of the greater sciatic foramen, and passes through the ischial spine, sacrospinous ligament, and sacrotuberous ligament.[6,7] Pudendal neuralgia develops after mechanical damage to the pudendal nerve, viral infections, and immunological processes.[8] The mechanical damage to the nerve can be also called as pudendal nerve entrapment. This entrapment may occur following the pelvic floor muscle spasm (levator ani or obturator internus), the pressure from the surrounding ligaments (sacrospinous, sacrotuberous), and the trauma of the scar tissue or surgery.
Pudendal nerve entrapment as source of intractable perineal pain.
Update in
pudendal nerve entrapment syndrome: an approach anatomicsurgical, diagnostic and therapeutic.
Hibner has extensive experience in the treatment of chronic pelvic pain and is one of the few physicians actively involved in surgical correction of
pudendal nerve entrapment.
Pudendal nerve entrapment is often exacerbated by sitting (not on a toilet seat, however) and is reduced in a standing position.
Pudendal neuralgia by pudendal nerve entrapment is described as severe, sharp pain along the course of the pudendal nerve.
A working diagnosis of pudendal nerve entrapment was reached.
Surgery is also an option in rare cases of
pudendal nerve entrapment.
Sacrospinous colpopexy: management of postoperative
pudendal nerve entrapment. Obstetrics and Gynecology, 8(4), 713.
In fact, pudendal neuralgia and
pudendal nerve entrapment specifically may be caused by various forms of pelvic trauma, from vaginal delivery (with or without instrumentation) and heavy lifting or falls on the back or pelvis, to previous gynecologic surgery such as hysterectomy cystocele repair, and mesh procedures for prolapse and incontinence.
Pudendal nerve entrapment can be caused by prior surgeries, childbirth, chronic constipation, heavy exercise like muscle building, or a hard fall on the backside.
Both physicians said pudendal nerve entrapment is difficult to diagnosis, and that a standard of care needs to be developed for both diagnostic and treatment options.