Pudendal nerve entrapment is among the most important causes of chronic pelvic pain and arises from the compression of the pudendal nerve along its anatomical course. Making the diagnosis is more difficult than in other conditions.
Why Does Pudendal Nerve Entrapment Occur and What Are Its Signs?
Sitting continuously for long periods, cycling for many years, lifting weights, a difficult pregnancy, a difficult birth, inflammatory or autoimmune disease, endometriosis, recurrent infection, an accident affecting the pelvic area and falls are the most common causes.
The most common symptoms of pudendal nerve entrapment are burning, numbness, tenderness, pain of an electric shock or stabbing type, the sensation of a foreign body or lump in the vagina and the rectum, a twisting or squeezing sensation, constipation, pain during bowel movements, burning when passing urine, pain during sexual intercourse, sexual dysfunction and loss of sensation.
How Is Pudendal Nerve Entrapment Diagnosed?
As we stated at the beginning, pudendal nerve entrapment is among the conditions that are the most difficult to diagnose. In making the diagnosis, the most important point is the patient’s history, her signs and the neuropelveological examination. In the examination, the affected nerve root is examined in terms of pain and loss of function. The functions of the nerves in the whole pelvic area, and the presence of a mass that could press on the nerve, can be investigated with MRI and CT. The most important method in making the diagnosis is imaging performed as 3 Tesla MRI and tractography.
What Is the Treatment of Pudendal Nerve Entrapment?
With the pudendal nerve block method, using a very fine and long needle, the pain that develops as a result of the nerve being under pressure can be relieved by numbing it with a local anaesthetic given around the nerve. In addition, in situations where this treatment method is not sufficient, laparoscopic and robotic surgery can also be preferred.
QUESTIONS
What Is Pudendal Nerve Entrapment?
Pudendal nerve entrapment refers to a pathological pain that arises from the compression of the pudendal nerve along its anatomical course.
Are Pudendal Nerve Entrapment and Alcock Syndrome the Same?
They are not the same. If the pudendal nerve is compressed while passing through Alcock’s canal, it takes the name Alcock canal syndrome.
Why Does Pudendal Nerve Entrapment Occur?
The most common causes of pudendal nerve entrapment are sitting continuously for long periods, cycling for many years, lifting weights, a difficult pregnancy, a difficult birth, inflammatory or autoimmune disease, endometriosis, recurrent infection, and an accident or fall affecting the pelvic area.
How Does Pudendal Nerve Entrapment Occur?
When the pudendal nerve is compressed along its anatomical course, pudendal nerve entrapment occurs.
In Whom Is Pudendal Nerve Entrapment Most Often Seen?
Pudendal nerve entrapment is seen most often in people who work sitting for long periods, who have cycled for many years, who constantly lift heavy loads, who have had a difficult pregnancy and a difficult birth, who have an inflammatory or autoimmune disease and who have been exposed to an accident or fall affecting the pelvic area.
Where Does Pudendal Nerve Entrapment Occur?
Pudendal nerve entrapment occurs in the areas supplied by the pudendal nerve or its branches, and most of all in the organs of the whole pelvic area and in the tissues the pudendal nerve reaches, making itself felt through pain.
What Are the Signs of Pudendal Nerve Entrapment?
The most common signs of pudendal nerve entrapment are burning, numbness, tenderness, pain of an electric shock or stabbing type, the sensation of a foreign body or lump in the vagina and the rectum, a twisting or squeezing sensation, constipation, pain during bowel movements, burning when passing urine, pain during sexual intercourse, sexual dysfunction and loss of sensation.
How Is Pudendal Nerve Entrapment Diagnosed?
In the diagnosis of pudendal nerve entrapment, the patient’s history, her signs and the identification of the situations that reduce and increase her pain are decisive. The most important methods in making the diagnosis are imaging performed as 3 Tesla MRI and tractography.
What Are the Treatment Methods for Pudendal Nerve Entrapment?
After the diagnosis, treatments are applied that will remove the tension and tightness in the muscles pressing on the nerves. The patient should rest lying on her back on a firm and flat bed. Because lying on the back reduces the pressure on the nerves, it relieves the pain and the patient can thus rest. In addition, with the pudendal nerve block method, using a very fine and long needle, the pain that develops as a result of the nerve being under pressure can be relieved by numbing it with a local anaesthetic given around the nerve.