Pudendal Nerve Syndrome (Syndrome of Alcock’s tunnel)

2001 ◽  
pp. 209-212
Keyword(s):  
Pudendal Nerve

Anatomy of the Pudendal Nerve at the Urogenital Diaphragm—A New Critical Site for Nerve Entrapment

2006 ◽  
Vol 22 (06) ◽  
Author(s):  
Oskar Aszmann ◽  
Johannes Ebmer ◽  
Stephan Hruby ◽  
A. Dellon
Keyword(s):  
Pudendal Nerve ◽  
Nerve Entrapment ◽  
Critical Site

Pudendal nerve release for lower urinary tract symptoms in young males

2020 ◽  
Author(s):  
Fouad Aoun ◽  
Georges Mjaess ◽  
Bernard Akl ◽  
Dany Nassar ◽  
Anthony Kallas Chemaly ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Lower Urinary Tract Symptoms ◽  
Lower Urinary Tract ◽  
Pudendal Nerve ◽  
Young Males ◽  
Urinary Tract Symptoms ◽  
Nerve Release ◽  
Lower Urinary

scholarly journals Bilateral electrical pudendal nerve stimulation as additional therapy for lower urinary tract dysfunction when stage II sacral neuromodulator fails: a case report

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shan Chen ◽  
Siyou Wang ◽  
Yunqiu Gao ◽  
Xiaolian Lu ◽  
Jiasheng Yan ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Nerve Stimulation ◽  
Lower Urinary Tract ◽  
Pudendal Nerve ◽  
Sacral Neuromodulation ◽  
Lower Urinary Tract Dysfunction ◽  
Urinary Frequency ◽  
Pudendal Nerve Stimulation ◽  
Additional Therapy ◽  
Lower Urinary

Abstract Background Sacral neuromodulation (SNM) has become an effective therapy for patients with lower urinary tract dysfunction (LUTD) who do not respond to conservative treatment. However, an effective treatment strategy for patients who fail SNM has not yet been identified. An option for LUTD is needed when the clinical response to the SNM diminishes. Case presentation A 51-year-old Chinese man presented to an outpatient clinic complaining of difficulty in urination for > 3 years. The patient also complained of urinary frequency and urgency, accompanied by perineal discomfort. He was diagnosed with LUTD based on his symptoms and previous examinations. The patient underwent sacral neuromodulation with a permanent implantable pulse generator (IPG) (provided free of charge by Chengnuo Medical Technology Co., Ltd.; General Stim, Hangzhou, China) in the left buttock, as he participated in the company’s clinical trial to test the long-term effects of IPG. He reported loss of efficacy of the device 3 months after the implantation. We performed bilateral electrical pudendal nerve stimulation (EPNS) therapy for him. After 2 weeks of treatment, he began to report smooth voiding within 2 h after EPNS, and a moderate improvement in urinary frequency, urgency, and perineal discomfort. After 4 weeks of EPNS, the patient reported > 50% improvement in his urination, evaluated with the short form of the International Consultation on Incontinence Questionnaire for Male Lower Urinary Tract Symptoms. He reported smooth voiding, moderate improvements in urinary frequency and urgency, and the disappearance of the perineal discomfort. He also reported improved sleep and erections. The patient was discharged after 8 weeks of EPNS treatment. Conclusion EPNS could be an option as an additional therapy for patients with LUTD who have failed SNM.

Is pudendal nerve entrapment a potential cause for weak ejaculation?

2021 ◽  
Author(s):  
Fouad Aoun ◽  
Georges Mjaess ◽  
Eddy Lilly ◽  
Nour Khalil ◽  
Georges Abi Tayeh ◽  
...  
Keyword(s):  
Pudendal Nerve ◽  
Nerve Entrapment ◽  
Pudendal Nerve Entrapment

scholarly journals Intraoperative monitoring for tethered cord surgery: an update

2004 ◽  
Vol 16 (2) ◽  
pp. E8 ◽  
Author(s):  
Karl F. Kothbauer ◽  
Klaus Novak
Keyword(s):  
Electrical Stimulation ◽  
Anal Sphincter ◽  
External Anal Sphincter ◽  
Continuous Monitoring ◽  
Pudendal Nerve ◽  
Tethered Cord ◽  
Sensory Pathways ◽  
Functional Integrity ◽  
Muscle Responses ◽  
Stimulation Of

Object Intraoperative neurophysiological recording techniques have found increasing use in neurosurgical practice. The development of new recording techniques feasible while the patient receives a general anesthetic have improved their practical use in a similar way to the use of digital recording, documentation, and video technology. This review intends to provide an update on the techniques used and their validity. Methods Two principal methods are used for intraoperative neurophysiological testing during tethered cord release. Mapping identifies functional neural structures, namely nerve roots, and monitoring provides continuous information on the functional integrity of motor and sensory pathways as well as reflex circuitry. Mapping is performed mostly by using direct electrical stimulation of a structure within the surgical field and recording at a distant site, usually a muscle. Sensory mapping can also be performed with peripheral stimulation and recording within the surgical site. Monitoring of the motor system is achieved with motor evoked potentials. These are evoked by transcranial electrical stimulation and recorded from limb muscles and the external anal sphincter. The presence or absence of muscle responses are the parameters monitored. Sensory potentials evoked by tibial or pudendal nerve stimulation and recorded from the dorsal columns via an epidurally inserted electrode and/or from the scalp as cortical responses are used to access the integrity of sensory pathways. Amplitudes and latencies of these responses are then interpreted. The bulbocavernosus reflex, with stimulation of the pudendal nerve and recording of muscle responses in the external anal sphincter, is used for continuous monitoring of the reflex circuitry. Presence or absence of this response is the pertinent parameter that is monitored. Conclusions Intraoperative neurophysiology provides a wide and reliable set of techniques for intraoperative identification of neural structures and continuous monitoring of their functional integrity.

scholarly journals Transischiorectal fossa approach for resection of pudendal nerve schwannoma: case report

2016 ◽  
Vol 25 (5) ◽  
pp. 636-639 ◽  
Author(s):  
Stephanie Chen ◽  
Brandon Gaynor ◽  
Allan D. Levi
Keyword(s):  
Pelvic Pain ◽  
Pudendal Nerve ◽  
English Language ◽  
Case Reports ◽  
Laparoscopic Approach ◽  
Direct Access ◽  
Surgical Approaches ◽  
Complete Relief ◽  
Pelvic Muscles ◽  
Intraoperative Electrophysiological Monitoring

Pudendal nerve schwannomas are very rare, with only two cases reported in the English-language literature. The surgical approaches described in these two case reports are the transgluteal approach and the laparoscopic approach. The authors present the case of a patient with progressive pelvic pain radiating ipsilaterally into her groin, vagina, and rectum, who was subsequently found to have a pudendal schwannoma. The authors used a transischiorectal fossa approach and intraoperative electrophysiological monitoring and successfully excised the tumor. This approach has the advantage of direct access to Alcock's canal with minimal disruption of the pelvic muscles and ligaments. The patient experienced complete relief of her pelvic pain after the procedure.

scholarly journals Postless Hip Arthroscopy: A Safer Alternative for Treatment of Femoracetabular Impingement Syndrome

2021 ◽  
Vol 1 (3) ◽  
pp. 263502542110067
Author(s):  
Michael B. Held ◽  
Liana J. Tedesco ◽  
Mario H. Lobao ◽  
T. Sean Lynch
Keyword(s):  
Hip Joint ◽  
Hip Arthroscopy ◽  
Pudendal Nerve ◽  
Patient Positioning ◽  
Central Compartment ◽  
Operating Table ◽  
Complication Rates ◽  
Iatrogenic Complications ◽  
Diagnostic Arthroscopy ◽  
Hip Distraction

Background: Hip arthroscopy for femoroacetabular impingement (FAI) syndrome continues to gain popularity and indications for its use are expanding. Though low complication rates have previously been reported, there are iatrogenic complications specific to the use of the perineal post, such as pudendal nerve injuries, and possible pressure skin necrosis that warrant concern in the healthy young patient. The risk of these complications are increased during simultaneous bilateral hip arthroscopy. Indications: We describe a new technique, which will prevent such problems by using a postless pink pad technique in order to achieve adequate hip distraction. Technique Description: Arthroscopic investigation begins with proper, safe patient positioning in order to gain access to the hip joint with sufficient joint distraction. In the postless technique, a dense foam pad is utilized in lieu of a perineal post. The static friction between the pad, bed, and the patient counters the manual gross traction necessary to distract the hip joint while preventing the patient from sliding down or off of the operating table. The postless technique avoids pressure to the perineum and also allows for greater range of motion during dynamic intraoperative examination and femoroplasty. After hip distraction, standard portal placement allows for access to the central compartment in order to assess intraarticular pathology. Once identified on diagnostic arthroscopy, appropriate techniques are utilized to correct acetabular-sided pincer lesions, labral tears, and femoral-sided cam deformities. Results: When discussing this technique with patients, it is important to highlight that it diminishes the possibility of iatrogenic pressure injury to the pudendal nerve and skin of the perineum. The risk of these injuries typically occurs when the pudenal nerve is compressed against the post during traction and abduction. As such, postless technique prevents any compression and pressure to these regions. Discussion/Conclusion: Hip arthroscopy is a minimally invasive, low morbidity technique for treating a variety of chondral, ligamentous, and bony conditions of the hip. However, studies suggest that pudenal nerve injury is seen in up to 4.3% of patients following hip arthroscopy. Given avoidance of iatrogenic post complications, we describe a postless technique for achieving hip distraction during hip arthroscopy.

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