title: Anatomic basis of chronic perineal pain: role of the pudendal nerve.
abstract: Our anatomic findings have led us to define conflictual relations that may be encountered in their course by the pudendal n. and its branches. Starting from the clinical study of a group of patients suffering from chronic perineal pain in the seated position, we have defined, beginning with the cadaver, three possible conflictual settings: in the constriction between the sacrotuberal and sacrospinal ligaments; in the pudendal canal of Alcock; and during the straddling of the falciform process of the sacro-tuberal ligament by the pudendal n. and its branches. Consequently, considering so-called idiopathic perineal pain as an entrapment syndrome, the clinical and neurophysiologic arguments and infiltration tests have led us to define a surgical strategy which has currently given 70% of good results in 170 operated patients. Earlier diagnosis should improve on this.
authors.affiliation: Laboratoire d' Anatomie, Faculté de Médcine, Nantes, France.
authors.forename: R
authors.initials: R
authors.lastname: Robert
authors.forename: D
authors.initials: D
authors.lastname: Prat-Pradal
authors.forename: J J
authors.initials: JJ
authors.lastname: Labat
authors.forename: M
authors.initials: M
authors.lastname: Bensignor
authors.forename: S
authors.initials: S
authors.lastname: Raoul
authors.forename: R
authors.initials: R
authors.lastname: Rebai
authors.forename: J
authors.initials: J
authors.lastname: Leborgne
mesh_terms: D002102:Cadaver; D002908:Chronic Disease; D004210:Dissection; D005260:Female; D006801:Humans; D008160:Lumbosacral Plexus / Q000033:anatomy & histology*; D008297:Male; D009469:Neuromuscular Junction / Q000033:anatomy & histology; D017773:Pelvic Floor / Q000033:anatomy & histology / Q000294:innervation*; D017699:Pelvic Pain / Q000209:etiology*; D010502:Perineum / Q000033:anatomy & histology / Q000294:innervation* / Q000601:surgery; D012016:Reference Values