New, simple, ultrasound-guided infiltration of the pudendal nerve: topographic basics.
OBJECTIVE
We report the topographic relationship of the pudendal nerve to the accompanying pudendal vessels and the ischial spine and provide the basics for an ultrasonographic depiction of these structures.


METHODS
Twenty-nine female and 29 male adult human cadavers were positioned prone to expose the deep gluteal region. In 58 left and 58 right pelves the course of the pudendal nerve and vessels at the ischial spine were evaluated and analyzed statistically (n = 116).


RESULTS
Multitrunked pudendal nerves were found in 40.5 percent with a left-vs.-right ratio of 1:1.5. The diameters of the single-trunked nerves ranged from 1.3 to 6.8 (mean 3.6 +/- 1.1) mm. In 75.9 percent the pudendal nerve was found medial to the accompanying internal pudendal artery. The distance to the artery ranged from 17.2 mm medial to 8 mm lateral (mean, 3.4 mm medial +/- 4.1 mm). The distance to the tip of the ischial spine ranged from 13.4 mm medial to 7.4 mm lateral (mean, 2.1 mm medial +/- 3.7 mm).


CONCLUSIONS
The knowledge of the close spatial relationship between the pudendal nerve and the internal pudendal artery is important for any infiltration technique and even surgical release. It demands real-time, visually controlled infiltration techniques, such as with ultrasound.
Gruber
H
H
Institute of Anatomy and Histology, University Hospital, Innsbruck, Austria.
Kovacs
P
P
Piegger
J
J
Brenner
E
E
D000368:Aged; D000369:Aged, 80 and over; D002102:Cadaver; D005260:Female; D006801:Humans; D008160:Lumbosacral Plexus / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D012445:Sacrococcygeal Region / Q000098:blood supply* / Q000294:innervation; D018084:Ultrasonography, Interventional / Q000379:methods*