Pudendal Nerve Entrapment - urological, genital, or rectal structures

[Guest guest]

PUDENDAL NERVE ENTRAPMENT

Q What is pudendal nerve entrapment and how is it treated?

DR. AARON G. FILLER RESPONDS from

http://journals.lww.com/neurologynow/Fulltext/2010/06020/Ask_the_Experts__Nerve_\

Entrapment.23.aspx

A nerve entrapment occurs when a nerve becomes pinched, squeezed, or stuck to

another tissue in the body, resulting in pain, numbness, and weakness. The most

common and widely known entrapment is carpal tunnel syndrome, which occurs when

the median nerve gets squeezed at the wrist.

The pudendal nerve carries movement and sensation signals to the skin between

the legs, as well as to the urogenital (urinary and genital) structures, rectum,

and bladder. An entrapped pudendal nerve can cause pain, numbness, or abnormal

function in any part of those structures.

Patients with symptoms affecting the lower abdomen and the urological, genital,

or rectal structures should be evaluated first by a gynecologist, urologist, or

general surgeon. If it becomes clear that the tissues in these areas are normal,

the possibility of a neurological syndrome is investigated.

Pudendal nerve entrapment can be diagnosed by an electrical test (pudendal nerve

latency test) or by a special imaging technique called magnetic resonance

neurography (MR neurography). MR neurography is a specialized MRI that shows the

nerves. If an entrapment is discovered, specialists guided by MRI can inject

anesthetic, steroids, or anti-scarring materials into muscles along the course

of the pudendal nerve. The injections help prove the diagnosis and may also

relieve the condition. Recently, medical journals have reported on a variety of

less invasive (minimal access) surgeries that can release the nerve entrapment

and allow the nerves to heal so the symptoms will resolve.

*****************************************************************

Dr. Filler is a neurosurgeon who specializes in the treatment of nerve disorders

at the Institute for Nerve Medicine in Santa , CA. He is also a former

director of peripheral nerve surgery at UCLA.