Irritation of the pudendal nerve | Pudendal nerve – course and failure

Irritation of the pudendal nerve

The pudendal nerve can be irritated by the layers of tissue surrounding it. If permanent pressure is exerted on a nerve, e.g. due to incorrect posture or overloading, this can lead to local nerve irritation, which may spread further. The irritation of the pudendal nerve usually manifests itself in a very similar way to the damage to the nerve.

There may be severe pain in the area between the anus and the genitals, which may radiate to varying degrees. In addition, functions such as urination or bowel movements may be restricted. However, nerve irritation does not have to occur suddenly, but can also become increasingly severe over time. If a nerve irritation is not treated, it can also develop into nerve inflammation.

What role does the pudendal nerve play in incontinence?

Damage to the pudendal nerve can lead to an impairment of continence.This is due to the fact that a nerve end branch of the pudendal nerve, the inferior rectal nerve, supplies the pelvic floor muscles. This supports the regulation of urination by tensing and relaxing. If the pudendal nerve is damaged, the pelvic floor muscles cannot perform their function, which in turn leads to incontinence.

What is Nervus Pudendus Syndrome?

Pudendal nerve syndrome is a condition in which the pudendal nerve is damaged or permanently irritated. This is accompanied by sudden, very severe pain in the genital and anal region. In the pelvic region, the pudendal nerve passes through several openings until it finally passes through the so-called ‘Alcock’ channel. This channel represents a narrow point where it can quickly become trapped and thus damage or irritate the pudendal nerve. If the nerve is damaged, continence, sexual function and general movement may be restricted.

Nervus Pudendus Blockage

The Nervus Pudendus Blockade, also called Pudendus Block, is used for severe birth pains. In this procedure, the pudendal nerve is anaesthetized with a local anaesthetic using a long cannula, which is intended to relieve the pain in the area around the vagina of the pregnant woman. During the birth of a woman, tears may occur in the perineal region, so-called perineal incisions or perineal tears.

In order to make this pain as bearable as possible for the woman giving birth, in addition to the natural pain of childbirth, the pudendal block is performed. The local anesthesia of the pudendal nerve has the advantage that the uterine muscles cannot be affected by it and thus the pressing urge and the contractions are always maintained. The procedure is usually only performed after the cervix has been fully opened in the expulsion phase.

The local anesthetic usually lasts about one hour. This may even provide time to suture a possible perineal tear. The aim of the Nervus Pudendus Blockade is to relieve pain, not to completely stop it. In some cases, the blockage has no effect at all, which is why it is now usually replaced by peridual anesthesia.