- Pudendal nerve entrapment
Pudendal nerve entrapment (PNE) is a source of
chronic pain, in which the pudendal nerve(located in the pelvis) is entrapped or compressed. Pain is worsened by sitting, and can include prickling, stabbing, burning, numbness, and the sense of a foreign object in the urethra, vagina, or rectum. In addition to pain, symptoms can include sexual dysfunction, impotence, anal and urinary incontinence.
PNE can be caused by
pregnancy, scarring due to surgeryand accidents. Anatomic abnormalities can result in PNE due to the pudendal nerve being fused to different parts of the anatomy, or trapped between the aforementioned ligaments. Heavy and prolonged bicycling, especially if an inappropriately shaped or incorrectly positioned bicycle seat is used, may eventually thicken the sacrotuberous and/or sacrospinous ligaments and trap the nerve between them, resulting in PNE.
There are stretches and exercises which have provided reduced levels of pain for some people. There are different sources of pain for people since there are so many ligament, muscles and nerves in the area. Sometimes women do pelvic floor exercises for compression after childbirth. However, there have been cases where the wrong stretches make the constant pain worse. Some people need to strengthen the muscles, others should stretch, while for some people it is purely
neurological. There have been cases where doing stretches have helped bicyclists. A helpful stretch for some is bending over and touching your toes. Another stretch includes bringing your knee to your chest on the compressed side while laying on your back. One more possibly helpful stretch for bicyclists include sitting in the lotus position and moving your head to the ground supporting yourself with your hands and keeping your buttocks up. Stretches should not be held long (about 8 seconds) and be spreadout through the day. Acupuncturehas helped decrease painlevels for some people, but is generally ineffective.fact|date=February 2008 Chiropractic adjustments to the lower back have also helped some patients with pudendal nerve issues.
Alcock canal infiltration with corticosteroids is a minimally invasive technique which allows for pain relief and could be tried when physical therapy has failed and before surgery.
Decompression surgery is done primarily in
Nantes, France, Aix-en-Provence, France, Oklahoma City, Oklahoma, www.urogynecologist.com, Phoenix, Arizona, Lake Elmo, Minnesota, Baltimore, MD, Santa Monica, CA, Houston, Texas, Switzerland, Belgium, Nashua, NHand in Egypt. The validity of decompression surgery as a treatment and the existence of entrapment as a cause of pelvic pain are controversial. While certain doctors will prescribe decompression surgery, others will not. Notably, in February 2003 the European Association of Urologyin its "Guidelines on Pelvic Pain" said:
:"the reality is that pudendal nerve neuropathy is probably only a likely diagnosis if the pain is unilateral, has a burning quality and is exacerbated by unilateral rectal palpation of the ischial spine, and the pudendal motor latency is delayed on that side only. However, such cases account for only a small proportion of all those presenting with perineal pain and the proof of the diagnosis resting on relief of pain following decompression of the nerve in Alcock's canal is rarely achieved. The value of the clinical neurophysiological investigations is debatable; some centres in Europe claim that the investigations have great sensitivity (1,2), while other centres, which also have a specialized interest in pelvic floor neurophysiology, have not positively identified any cases." [http://www.chronicpelvicpain.us/viewtopic.php?t=1506&start=15]
Three types of surgery have been done to decompress the pudendal nerve: transperineal, transgluteal and transichiorectal. The results on pain are very similar (around 60% of cure). Impotence, anal and urinary incontinence can also be cured by these procedures.
* [http://www.tipna.org PNE web forum and community]
* [http://www.pudendalhelp.com Pudendal Help]
* [http://www.pudendal.com Pudendal.com by Groupement Européen de Périnéologie]
* [http://www.spuninfo.org Society for Pudendal Neuralgia]
* [http://www.pudendal.info Pudendal.info: PNE Web Community]
* [http://www.neurosurgery-quarterly.com/pt/re/neurosurgquart/abstract.00013414-200803000-00001.htm Treatment and Diagnoisis of Pudendal nerve clinical syndromes]
*Am J Phys Med Rehabil. 2003 Jun;82(6):479-84. (PMID 12820792)
*Eur Urol. 2005 Mar;47(3):277-86 (PMID 15716187)
*Clin Exp Neurol. 1991;28:191-6. (PMID 1821826)
*BMC Surg 2004, 4(1):15 [http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=529451 full text]
Wikimedia Foundation. 2010.
Look at other dictionaries:
Pudendal nerve — Infobox Nerve Name = Pudendal nerve Latin = nervus pudendus GraySubject = 213 GrayPage = 967 Caption = Pudendal nerve, course and branches Caption2 = Sacral plexus of the right side. (Inferior pudendal labeled at bottom right.) Innervates =… … Wikipedia
Nerve compression syndrome — Trapped nerve redirects here. For other uses, see Trapped nerve (disambiguation). Nerve compression syndrome Classification and external resources ICD 9 355.9 MeSH … Wikipedia
Common fibular nerve — Peroneal nerve redirects here. This is not to be confused with Perineal nerve. Nerve: Common fibular Nerves of the right lower extremity Posterior view. (Common fibular labeled at center right as common peroneal.) Latin n. fibularis communis, n.… … Wikipedia
Magnetic resonance neurography — Bilateral Split Sciatic Nerve Magnetic resonance neurography (MRN) is the direct imaging of nerves in the body by optimizing selectivity for unique MRI water properties of nerves. It is a modification of magnetic resonance imaging. This technique … Wikipedia
Cycling — Protesters cycling in Chamonix in 2003 … Wikipedia
Névralgie pudendale — syndrome d Alcock Classification et ressources externes trajet du nerf pudental dans le périnée La névralgie pudendale est une douleur neuropathique qui concerne … Wikipédia en Français
Nervio pudendo — El nervio pudendo es un nervio que se encuentra en la región pélvica y que inerva los genitales externos de ambos sexos, así como también los esfínteres de la vejiga urinaria y del recto. Contenido … Wikipedia Español
Persistent genital arousal disorder — (PGAD), originally called Persistent Sexual Arousal Syndrome (PSAS) and also known as Restless Genital Syndrome or Mempin Syndrome (ReGS or RGS), results in a spontaneous, persistent, and uncontrollable genital arousal, with or without… … Wikipedia
PNE — can be used to abbreviate the subatomic particles, Proton, Neutron and Electron, when referring to them en masse .PNE as an acronym could refer to:*Pacific National Exhibition an exhibition in Vancouver, British Columbia *Preston North End F.C.… … Wikipedia
Sacrotuberous ligament — Infobox Ligament Name = Sacrotuberous ligament Latin = ligamentum sacrotuberale GraySubject = 80 GrayPage = 309 Caption = Articulations of pelvis, anterior view, with greater sciatic foramen (labeled in red) and its boundaries. Caption2 =… … Wikipedia