Pudendal nerve entrapment is a rare and difficult-to-diagnose important cause of chronic pelvic pain. In the scientific world it is also known as “Alcock Canal Syndrome”. Pudendal nerve entrapment refers to a pathological, very severe pain arising from the compression of the pudendal nerve along its anatomical course.
What Is Alcock Canal Syndrome?
It can most often become compressed while passing between the ligaments (the sacrospinous and sacrotuberous ligaments); if it becomes compressed while passing through the Alcock canal, also called the pudendal canal, this is called “Alcock Canal Syndrome”.
What Are the Complaints in Patients?
This pain is seen in the areas supplied by the pudendal nerve or its branches. In women these areas are the clitoris, the mons pubis (the area where the genital hair grows), the vulva, the lower third of the vagina and the labia. However, although the pain is generally one-sided, it can be felt throughout the pelvis.
The symptoms may begin suddenly or may appear gradually, increasing over time. Typically the pain increases progressively during the day and worsens on sitting. The pain can be one-sided or two-sided depending on which nerve branches are affected. However, in the clinic it is usually in the form of one-sided somatic pain. In these areas the skin can also be excessively sensitive to touch and pressure.
What Are Its Symptoms?
Among the possible symptoms there may be burning, numbness, tenderness, pain like an electric shock or like a knife being driven in, a feeling of a foreign body or lump in the vagina and rectum, a feeling of twisting or squeezing, constipation, pain during bowel movements, burning when urinating, pain during sexual intercourse, sexual dysfunction and loss of sensation.
What Is the Cause of This Painful Condition?
Among the causes can be listed repeated mechanical trauma in the pelvic region (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, a fall or surgery affecting the pelvic region. However, it can also occur without any clear clinical history.