Pudendal nerve entrapment

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Pudendal nerve entrapment
Synonyms	Alcock canal syndrome, pudendal neuralgia
Pronounce	N/A
Specialty	Neurology, Urology, Gynecology
Symptoms	Chronic pain in the pelvis, genitals, or perineum
Complications	N/A
Onset	Gradual
Duration	Long-term
Types	N/A
Causes	Compression of the pudendal nerve
Risks	Cycling, childbirth, pelvic surgery
Diagnosis	Clinical examination, nerve conduction study, MRI
Differential diagnosis	Interstitial cystitis, prostatitis, vulvodynia
Prevention	N/A
Treatment	Physical therapy, nerve block, surgery
Medication	Pain management, anticonvulsants, antidepressants
Prognosis	Variable, can be managed with treatment
Frequency	Rare
Deaths	N/A

CT image guided injection of the pudendal nerve

Pudendal nerve entrapment (PNE), also known as Alcock canal syndrome, is a condition that results in chronic pelvic pain. The pudendal nerve is the main nerve of the perineum. It carries sensation from the external genitalia of both sexes and the skin around the anus and perineum, as well the motor supply to various pelvic muscles, including the male or female external urethral sphincter and the external anal sphincter. If this nerve is damaged or compressed, it can cause pain, discomfort or numbness in these areas.

Causes

Pudendal nerve entrapment can be caused by a variety of factors. These include pregnancy, surgery, cycling, squatting exercises, and trauma to the area. In some cases, the cause of PNE is unknown.

Symptoms

The symptoms of pudendal nerve entrapment can vary greatly from person to person. They may include:

• Pain in the perineum, genitals, or rectum
• Numbness or tingling in these areas
• Sexual dysfunction
• Urinary incontinence or fecal incontinence
• Constipation

Diagnosis

Diagnosis of pudendal nerve entrapment can be challenging, as the symptoms can be similar to other conditions. A thorough medical history and physical examination are essential. Diagnostic tests may include a nerve conduction study, MRI, or CT scan. In some cases, a pudendal nerve block may be performed to confirm the diagnosis.

Treatment

Treatment for pudendal nerve entrapment can include a variety of options, depending on the severity of the symptoms and the underlying cause of the condition. These may include:

• Physical therapy
• Medications to manage pain
• Nerve block injections
• Surgery

See also

• Pelvic pain
• Pudendal nerve
• Pudendal nerve block

References

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