User:R. Mohsin, Future UCSF Pharm.D./sandbox

Diagnosis

It is important to note that the duration of pain relief from pudendal nerve block is different per person. Main

Pudendal nerve entrapment (PNE), also known as Alcock canal syndrome, is an uncommon source of chronic pain, in which the pudendal nerve (located in the pelvis) is entrapped or compressed. Pain is positional and is worsened by sitting. However, standing or being in a reclined position can help decrease some of the pain.

Other symptoms a person may experience as well are genital numbness, fecal incontinence and urinary incontinence. In recent years, Pulsed radiofrequency (PRF) has become a more common method for managing chronic pain, and it has shown to have long-term benefits and low problem occurrences.

Anatomy
The pudendal nerve carries both motor and sensory axons. It stems from the spinal nerves S2-S4 of the sacral plexus. The nerve progresses through the piriformis and coccygeus muscles and exits the pelvis by passing through the greater sciatic foramen. The pudendal nerve then re-enters the pelvic cavity by passing through the lesser sciatic foramen. After re-entering the pelvis, it breaks off into three branches known as the inferior rectal branch, the perineal branch, and then dorsal sensory nerve of the penis or clitoris. These nerves can be easily injured due to their locations. This condition can greatly affect a persons’ quality of life. Pudendal neuralgia can be caused by many factors including inflammation, extreme cycling, and can even be secondary condition to childbirth. There are also four levels of Pudendal nerve entrapment compressions: entrapment below the piriformis muscle, entrapment that occurs between the sacrospinous and sacrotuberous ligament (most common cause), entrapment in the Alcock canal, and entrapment of the terminal branches.