Pudendal nerve entrapment

Pudendal nerve entrapment
Other namesAlcock canal syndrome
SpecialtyNeurology Edit this on Wikidata

Pudendal nerve entrapment (PNE), also known as Alcock canal syndrome,[1][2] is an uncommon[1][3][4] source of chronic pain in which the pudendal nerve (located in the pelvis) is entrapped or compressed in Alcock's canal. There are several different types of PNE based on the site of entrapment anatomically (see Anatomy).[5] Pain is positional and is worsened by sitting. Other symptoms include genital numbness, fecal incontinence and urinary incontinence.

The term pudendal neuralgia (PN) is often used interchangeably with "pudendal nerve entrapment". This condition can greatly affect a person's quality of life. Pudendal neuralgia can be caused by many factors including inflammation, extreme cycling, and can be a "secondary condition to childbirth".[6] A 2009 review study found both that "prevalence of PN is unknown and it seems to be a rare event" and that "there is no evidence to support equating the presence of this syndrome with a diagnosis of pudendal nerve entrapment," meaning that it could be possible to have all the symptoms of pudendal nerve entrapment (otherwise known as pudendal neuralgia) based on the criteria specified at Nantes in 2006, without having an entrapped pudendal nerve.[7]

A 2015 study of 13 normal female cadavers found that the pudendal nerve was attached or fixed to the sacrospinous ligament (therefore "entrapped") in all cadavers studied, suggesting that the diagnosis of pudendal nerve entrapment may be overestimated.[8]

  1. ^ a b 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. ^ Itza Santos F, Salinas J, Zarza D, Gómez Sancha F, Allona Almagro A (June 2010). "[Update in pudendal nerve entrapment syndrome: an approach anatomic-surgical, diagnostic and therapeutic]". Actas Urologicas Espanolas. 34 (6): 500–9. doi:10.1016/s2173-5786(10)70121-9. PMID 20510112.
  4. ^ Durante JA, Macintyre IG (December 2010). "Pudendal nerve entrapment in an Ironman athlete: a case report". The Journal of the Canadian Chiropractic Association. 54 (4): 276–81. PMC 2989401. PMID 21120020.
  5. ^ Filler AG (February 2009). "Diagnosis and treatment of pudendal nerve entrapment syndrome subtypes: imaging, injections, and minimal access surgery". Neurosurgical Focus. 26 (2): E9. doi:10.3171/FOC.2009.26.2.E9. PMID 19323602.
  6. ^ Pérez-López FR, Hita-Contreras F (December 2014). "Management of pudendal neuralgia". Climacteric. 17 (6): 654–6. doi:10.3109/13697137.2014.912263. PMID 24716710. S2CID 33039806.
  7. ^ 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.
  8. ^ Maldonado PA, Chin K, Garcia AA, Corton MM (November 2015). "Anatomic variations of pudendal nerve within pelvis and pudendal canal: clinical applications". American Journal of Obstetrics and Gynecology. 213 (5): 727.e1–6. doi:10.1016/j.ajog.2015.06.009. PMID 26070708.