The anatomy of the pudendal nerve and its branches and the clinical implications thereof

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University of Pretoria

Abstract

Knowledge of the course of the pudendal nerve (PN) is important when performing perineal surgery. Distances between landmarks were measured after PN dissections in 71 cadavers and after perineal procedures on 30 cadavers. Separate inferior rectal nerve (IRN) entry and medial position of the PN/IRN with shortened sacrospinous ligaments were often seen in black individuals. A PN block should therefore be placed more proximally and medially. The Richter’s stitch should be placed further from the ischial spine. During ischioanal procedures the IRN is at risk in white females, as it was more superficial. The dorsal nerve of the clitoris/penis (DNC/DNP) is in danger during the outside-in procedures in white or obese individuals, as it was closer to the inferior pubic ramus. The dorsal penile nerve block should be administered deeper in white and obese individuals, as the DNP was deeper. The above-mentioned findings should be verified in a clinical setting.

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Dissertation (MSc)--University of Pretoria, 2013.

Keywords

Pudendal nerve, Nerve, Perineal surgery, Inferior rectal nerve, Dorsal nerve of the clitoris/penis, Transobturator tape procedures, Pudendal nerve block, Richter’s stitch, Dorsal penile nerve block, Ischioanal procedures, Inferior pubic ramus, UCTD

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Van der Walt, S 2013, The anatomy of the pudendal nerve and its branches and the clinical implications thereof, MSc dissertation, University of Pretoria, Pretoria, viewed yymmdd <http://hdl.handle.net/2263/40701>