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Surgical and Radiologic Anatomy

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19.01.2024 | Original Article

Anatomy of the pudendal nerve in clinically important areas: a pictorial essay and narrative review

verfasst von: Jan Zapletal, O. Nanka, M. J. Halaska, K. Maxova, L. Hajkova Hympanova, L. Krofta, L. Rob

Erschienen in: Surgical and Radiologic Anatomy | Ausgabe 2/2024

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Abstract

Purpose

The pudendal nerve is an anatomical structure arising from the ventral branches of the spinal roots S2–S4. Its complex course may be affected by surrounding structures. This may result in irritation or entrapment of the nerve with subsequent clinical symptoms. Aim of this study is to review the anatomy of the pudendal nerve and to provide detailed photographic documentation of the areas with most frequent clinical impact which are essential for surgical approach.

Methods

Major medical databases were searched to identify all anatomical studies investigating pudendal nerve and its variability, and possible clinical outcome of these variants. Extracted data consisted of morphometric parameters, arrangement of the pudendal nerve at the level of roots, formation of pudendal nerve, position according to sacrospinal and sacrotuberal ligaments and its terminal branches. One female cadaver hemipelvis was dissected with common variability of separate course of inferior rectal nerve. During dissection photodocumentation was made to record course of pudendal nerve with focus on areas with recorded pathologies and areas exposed to iatrogenic damage during surgical procedures.

Results

Narrative review was done to provide background for photodocumentation. Unique photos of course of the pudendal nerve was made in areas with great clinical significance.

Conclusion

Knowledge of anatomical variations and course of the pudendal nerve is important for examinations and surgical interventions. Surgically exposed areas may become a site for iatrogenic damage of pudendal nerve; therefore, unique picture was made to clarify topographic relations.

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Titel: Anatomy of the pudendal nerve in clinically important areas: a pictorial essay and narrative review
verfasst von: Jan Zapletal
O. Nanka
M. J. Halaska
K. Maxova
L. Hajkova Hympanova
L. Krofta
L. Rob
Publikationsdatum: 19.01.2024
Verlag: Springer Paris
Erschienen in: Surgical and Radiologic Anatomy / Ausgabe 2/2024
Print ISSN: 0930-1038
Elektronische ISSN: 1279-8517
DOI: https://doi.org/10.1007/s00276-023-03285-7

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