1 Although entrapments affecting the distal peripheral nerves, such as carpal tunnel syndrome and cubital tunnel syndrome, are well understood by virtually every neurosurgeon and neurologist, there has been little interest in perineal neurology and neurosurgery. Urologists and gynecologists are focused on end organs so that neurological conditions affecting the perineum have been effectively re...

OBJECTIVE To show the value of computed tomography (CT) in selectively blocking the pudendal nerve in patients with long-term anogenital pain of uncertain etiology. We report a technique to selectively block the pudendal nerve using CT guidance in 2 patients with long-term anogenital pain. CASE REPORT In 1 patient, a competitive cyclist, the diagnosis of pudendal neuralgia was substantiated b...

Aims: This study was conducted to evaluate pudendal entrapment as an etiology of chronic pain, a diagnostic protocol for pudendal entrapment, and clinical response to surgical decompression. Methods: A case series of 58 consecutive patients with a diagnosis of pudendal entrapment, based on clinical factors, neurophysiologic studies, and response to pudendal nerve infiltrations, is described. Al...

The management of recurrent rectovaginal fistula after obstetric injury and cryptoglandular sepsis is considered a major surgical challenge. The fistula poses a significant negative psychosocial and sexual morbidity. In addition, the poor quality of local tissues due to previous attempts at surgical repair adds to this challenge. There are few data regarding the management of persistent or recu...

AIMS This study was conducted to evaluate pudendal entrapment as an etiology of chronic pain, a diagnostic protocol for pudendal entrapment, and clinical response to surgical decompression. METHODS A case series of 58 consecutive patients with a diagnosis of pudendal entrapment, based on clinical factors, neurophysiologic studies, and response to pudendal nerve infiltrations, is described. Al...

OBJECTIVE To digitally model (three-dimensional, 3D) the course of the pudendal arteries relative to the bony pelvis in the adult male, and to identify sites of compression with different bicycle riding positions as a potential cause of penile hypoxia and erectile dysfunction. SUBJECTS AND METHODS 3D models were made from computed tomography scans of one adult male pelvis (a healthy volunteer...

Most practitioners would agree that the main cause of urinary incontinence after RP is sphincter or neurological damage or urethral shortening due to the surgery. The external striated sphincter is tubular and has broad attachments over the fascia of the prostate near the apex. Its innervations arise from the pudendal nerves and the autonomic nerves in the pelvic plexus. Urinary continence reco...

Most of the publications about the surgical treatment of pudendal neuropathy are only interested by pain (1,2). This point of view is too reducing for a perineologist (3,4). Indeed, the compression or the stretch of one or the two pudendal nerves can provoke, besides perineodynia (pain) classically worse in seated position, proctalgia fugax, vulvodynia, urinary incontinence, anal incontinence o...