What Is the Pudendal Nerve?

The pudendal nerve comes from the pudendal plexus, and the nerve fibers are composed of the anterior branches of the phrenic nerves 2, 3, and 4 and contain many parasympathetic nerve fibers. It accompanies the internal genital arteries, leaves the pelvis from the lower edge of the piriformis muscle, bypasses the sciatic spine and returns to the pelvic cavity through the sciatic foramen. It passes through the genital canal along the outer wall of the sciatic anal fossa below the levator ani muscle and reaches Pussy. It emits the following branches in the sciatic rectal fossa: perineal nerve (superficial branch, deep branch), inferior rectal nerve, and dorsal nerve of penis (clitium). It is rare in the clinic, and symptoms such as dull feeling, tingling, and itching may appear in the nerve distribution area of the patient.

Basic Information

Visiting department

Obstetrics and Gynecology

Multiple groups

female

Common locations

Pussy

Common causes

Tumors, inflammation, and pregnancy in the pelvic cavity directly press the lower sacral plexus, the sacrum itself and the lesions in the spinal canal.

Common symptoms

Feeling dull, stinging, itching, urinary incontinence, difficulty urinating, impotence in men, etc.

Causes of genital neuralgia

In addition to pelvic tumors, inflammation, pregnancy and other direct compression of the lower sacral plexus, mostly related to the sacrum itself and the spinal canal lesions, the latter often occurs in the cone of the spinal cord and cauda equina.

Clinical manifestations of genital neuralgia

Feel abnormal

Symptoms such as dullness, tingling, and itching appear in the nerve distribution area. In severe cases, the symptoms disappear completely. Physical examination revealed signs of genital hypersensitivity.

2. Incontinence

Affects sphincter function and causes symptoms such as incontinence, difficulty urinating, or dyspnea.

3. Sexual decline

As the main symptom, impotence can occur in men with severe symptoms.

4. Anal reflex

To weaken or disappear.

Genital nerve stem pain examination

X-rays of the spine, orthosis, and lateral view are available, and CT and MRI are performed if necessary.

Diagnosis of genital neuralgia

1. Comprehensive inspection to determine that it is a spinal canal lesion, sacral lesion, pressure substance below the pelvic cavity or the neural stem itself is damaged.

2. It is often accompanied by low back pain, paravertebral tenderness and cramping pain, positive neck flexion test, and limited lumbar spine motion.

3. There are dry symptoms or plexus symptoms. The pelvic condition can be determined by digital anus or double consultation; when the Toma sign is positive, it indicates that the inflammation of the lumbosacral waist is likely to be large; if necessary, the film should be taken after cleaning the enema to exclude the tumor.

Diagnosis can be confirmed based on clinical manifestations and auxiliary examinations.

Complications of genital neuralgia

Incontinence and impotence can be concurrent.

Nerve neuralgia treatment

1. Mainly closed therapy, physical therapy, acupuncture and symptomatic treatment.

2. Surgery

For the pubic nerve trunk, it is clear that the pressure can be released, and the pressure can be removed. For the perineal itch, one side of the genital nerve can also be cut off (male patients should be cautious and generally not used).

3. Treatment for the cause.