Pudendal nerve entrapment

Pudendal Nerve Entrapment
Other names
  • Pudendal neuralgia
  • Alcock canal syndrome.[1][2]
  • Pudendal nerve entrapment syndrome.[3][4]
  • Pudendal canal syndrome.[5]
  • Pudendal syndrome.[6]
  • Pudendal neuropathy.[6]
  • Cyclist syndrome.[7]
  • Pudendal canal entrapment.[8]
  • Pudendal pain syndrome.[9]
SpecialtyNeurology
CausesMajor trauma, surgery, childbirth, cycling
Differential diagnosis
Frequency1 in 100,000[10]

Pudendal nerve entrapment is an uncommon, chronic pelvic pain condition in which the pudendal nerve (located in the pelvis) is entrapped and compressed. There are several different anatomic locations of potential entrapment (see Anatomy). Pudendal nerve entrapment is an example of nerve compression syndrome.

Pudendal neuralgia refers to neuropathic pain along the course of the pudendal nerve and in its distribution. This term is often used interchangeably with pudendal nerve entrapment. However, it has been suggested that the presence of symptoms of pudendal neuralgia alone should not be used to diagnose pudendal nerve entrapment. That is because it is possible to have all the symptoms of pudendal nerve entrapment, as per the diagnostic criteria specified at Nantes in 2006, without actually having an entrapped pudendal nerve.[11]

The pain is usually located in the perineum, and is worsened by sitting. Other potential symptoms include genital numbness, sexual dysfunction, bladder dysfunction or bowel dysfunction. Pudendal neuralgia can be caused by many factors including nerve compression or stretching of the nerve. Injuries during childbirth, sports such as cycling, chronic constipation and pelvic surgery have all been reported to cause pudendal neuralgia.

Management options include lifestyle adaptations, physical therapy, medications, long acting local anesthetic injections and others. Nerve decompression surgery is usually considered as a last resort. Pudendal neuralgia and pudendal nerve entrapment are generally not well-known by health care providers. This often results misdiagnosis or delayed diagnosis. If the pain is chronic and poorly controlled, pudendal neuralgia can greatly affect a person's quality of life, causing depression.

  1. ^ Insola A, Granata G, Padua L (September 2010). "Alcock canal syndrome due to obturator internus muscle fibrosis". Muscle & Nerve. 42 (3): 431–2. doi:10.1002/mus.21735. PMID 20665515. S2CID 206292116.
  2. ^ Possover M (April 2009). "Laparoscopic management of endopelvic etiologies of pudendal pain in 134 consecutive patients". The Journal of Urology. 181 (4): 1732–6. doi:10.1016/j.juro.2008.11.096. PMID 19233408.
  3. ^ Luesma, MJ; Galé, I; Fernando, J (23 July 2021). "Diagnostic and therapeutic algorithm for pudendal nerve entrapment syndrome". Medicina Clinica. 157 (2): 71–78. doi:10.1016/j.medcli.2021.02.012. PMID 33836860.
  4. ^ Cite error: The named reference Mylle2024 was invoked but never defined (see the help page).
  5. ^ Cite error: The named reference Beco_2004 was invoked but never defined (see the help page).
  6. ^ a b Antolak, SJ (November 2024). "The pudendal syndrome: A photo essay of nerve compression damage visualized at neurolysis in patients with chronic neuropathic pelvic pain". Neurourology and Urodynamics. 43 (8): 1883–1894. doi:10.1002/nau.25555. PMID 39032061.
  7. ^ Cite error: The named reference Durante_2010 was invoked but never defined (see the help page).
  8. ^ Cite error: The named reference Aoun2021 was invoked but never defined (see the help page).
  9. ^ Brown, SR; Hartley, JE; Hill, J; Scott, N; Williams, JG, eds. (2012). Contemporary Coloproctology. Springer Verlag London Limited. p. 417. ISBN 978-0-85729-888-1.
  10. ^ Cite error: The named reference Chowdhury2016 was invoked but never defined (see the help page).
  11. ^ Stav K, Dwyer PL, Roberts L (March 2009). "Pudendal neuralgia. Fact or fiction?". Obstetrical & Gynecological Survey. 64 (3): 190–9. doi:10.1097/ogx.0b013e318193324e. PMID 19238769. S2CID 23124781.
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