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KMID : 1040020210120020024
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International Journal of Pain
2021 Volume.12 No. 2 p.24 ~ p.30
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Decompression of Inferior Rectal Nerve in Refractory Perianal Pain Caused by Pudendal Nerve Entrapment: A Case Report
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Son Byung-Chul
Lee Chang-Ik
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Abstract
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Pudendal neuralgia is a painful neuropathy involving the pudendal nerve. The pudendal nerve comprises sensory and motor fibers supplying the anal, perineal, and genital regions. It branches off into the inferior rectal and perineal branches, and the dorsal nerve of the penis or clitoris. Therefore, the pain associated with pudendal neuralgia is localized to the vulva, vagina, clitoris, perineum, and rectum in females and to the glans penis, scrotum, perineum, and rectum in males. Isolated perianal pain may manifest as a symptom of pudendal neuralgia caused by pudendal nerve entrapment, but the comprehensive clinical features and treatment have yet to be reported. A 67-year-old female patient presented with a two-year history of persistent stabbing and tingling pain involving her left perianal area. The pain was triggered by a blunt trauma to the buttock and was especially severe in the seated position. Transgluteal surgery confirmed the location of pudendal nerve superior to the sacrotuberous ligament in the form of inferior rectal and perineal and dorsal nerves, and along the pudendal canal. This case demonstrates the importance of accurate anatomical knowledge of the pudendal nerve and its branches in surgical decompression of pudendal nerve entrapment.
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KEYWORD
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anatomy, inferior rectal nerve, pudendal nerve, sacrospinous ligament, sacrotuberous ligament
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