Introduction
The pudendal nerve is a nerve located within the pelvis that supplies the genitalia, anus, and perineum. It is an important component of the somatic nervous system, providing sensation to the area as well as control of musculature. Damage to the pudendal nerve can cause a variety of symptoms including pain, numbness, and loss of sensation. This article will discuss the anatomy, clinical implications, and treatment of pudendal nerve dysfunction.
Anatomy
The pudendal nerve is the main nerve of the perineum, a region of the body between the anus and the genitals. It is also known as the nervus erigentes, or “nerve of erection.” The nerve originates in the sacral plexus, which is a network of nerves located in the lower back. It then travels through the greater sciatic foramen, a large opening in the pelvic bone, and enters into the perineum. It passes through the ischiorectal fossa, a space between the ischium and rectum, and eventually divides into three branches: the perineal nerve, the dorsal nerve of the clitoris/penis, and the inferior rectal nerve. The nerve innervates the pelvic floor muscles, the external genitalia, the anal sphincter, and the rectum.
Clinical Implications
Damage to the pudendal nerve can cause a variety of symptoms including pain, numbness, and loss of sensation. Pudendal nerve entrapment is a condition where the nerve is compressed as it passes through the pelvic bones, causing pain, numbness, and tingling sensations in the perineum. It can also cause difficulty with urination, defecation, and sexual activity. Other causes of pudendal nerve dysfunction include trauma, childbirth, and compression from a tumor or cyst.
Treatment
Treatment for pudendal nerve dysfunction depends on the cause. In cases of pudendal nerve entrapment, physical therapy can be used to reduce the compression on the nerve. This includes stretching and strengthening exercises for the pelvic floor muscles, as well as manual techniques to release tight muscles. Surgery may also be necessary to decompress the nerve and relieve the symptoms. For other causes of nerve dysfunction, medications such as anti-inflammatories or muscle relaxants may be prescribed. Surgery may also be necessary in certain cases.
Conclusion
The pudendal nerve is an important component of the somatic nervous system, providing sensation and control of the muscles of the perineum. Damage to the nerve can cause a variety of symptoms, including pain, numbness, and loss of sensation. Treatment depends on the cause of the nerve dysfunction, and may include physical therapy, medications, and/or surgery.
References
Bajwa, S.J., Reyes-Gastelum, D., & Park, P. (2016). Pudendal nerve entrapment: diagnosis and management. Seminars in Interventional Radiology, 33(4), 383-389.
Bruno, M.A., & Kia, R.K. (2013). Pudendal nerve dysfunction: Damage, diagnosis, and treatment options. Current Pain and Headache Reports, 17(7), 341.
Joaquim, A.F., & MacMahon, J.E. (2009). Pudendal nerve entrapment: anatomy, diagnosis, and treatment. International Urogynecology Journal, 20(5), 551-558.