Anatomical variations of the pudendal nerve

Cadaveric investigation of the anatomical variations in 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.


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