Abstract
PURPOSE: Anesthetic infiltration of the pudendal nerve at the ischial spine can relieve perineal pain in cases of compression or distention. The aim of our study was to look for a real-time, visually controlled infiltration technique using ultrasound. METHODS: Fifty-three volunteers were examined in a prone position using a 3.5-MHz curved-array probe in color-coded Doppler mode. The deep gluteal region was scanned in two perpendicular planes, longitudinal and transverse to the internal pudendal artery. RESULTS: On the transverse planes the ischial spine, the sacrospinous ligament, and the internal pudendal artery were depicted in all but two cases. In 47.2 percent of the cases one trunk of the pudendal nerve was detected directly. Nerves consisting of more than one trunk were not found. The thickness of the nerve ranged between 3.5 and 7 mm. CONCLUSIONS: In almost one-half of the cases a direct ultrasound-guided infiltration of the pudendal nerve is possible. In the remaining cases the nerve can be detected and blocked indirectly, using the ischial spine or the internal pudendal artery as a landmark.
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Amarenco G, Lanoe Y, Ghnassia RT, Goudal H, Perrigot M. Syndrome du canal d'Alcock et névralgie périnéale. Rev Neurol (Paris) 1988;144:523–6.
Labat JJ, Robert R, Bensignor M, Buzelin JM. Les névralgies du nerf pudendal (honteux interne). J Urol (Paris) 1990;96:239–44.
Schmidt RA. Technique of pudendal nerve localization for block or stimulation. J Urol 1989;142:1528–31.
Amarenco G, Savatovsky I, Budet C, Perrigot M. Névralgies périnéales et syndrome du canal d'Alcock. Ann Urol (Paris) 1989;23:488–92.
Amarenco G, Le Cocquen-Amarenco A, Kerdraon J, Lacroix P, Adba MA, Lanoe Y. Les névralgies périnéales. Presse Med 1991;20:71–4.
Robert R, Prat-Pradal D, Labat JJ,et al. Anatomic basis of chronic perineal pain: role of the pudendal nerve. Surg Radiol Anat 1998;20:93–8.
Thoumas D, Leroi AM, Mauillon J,et al. Pudendal neuralgia: CT-guided pudendal nerve block technique. Abdom Imaging 1999;24:309–12.
Calvillo O, Skaribas IM, Rockett C. Computed tomography-guided pudendal nerve block. A new diagnostic approach to long-term anoperineal pain: a report of two cases. Reg Anesth Pain Med 2000;25:420–3.
Mauillon J, Thoumas D, Leroi AM, Freger P, Michot F, Denis P. Results of pudendal nerve neurolysis-transposition in twelve patients suffering from pudendal neuralgia. Dis Colon Rectum 1999;42:186–92.
Gruber H, Kovacs P, Piegger J, Brenner E. New, simple, ultrasound-guided infiltration of the pudendal nerve: topographic basics. Dis Colon Rectum 2001;44:000–00.
Graif M, Seton A, Nerubai J, Horoszowski H, Itzchak Y. Sciatic nerve: sonographic and anatomic-pathologic considerations. Radiology 1991;181:405–8.
Silvestri E, Martinoli LE, Derchi LE, Bertolotto M, Chiaramondia M, Rosenberg I. Echotexture of peripheral nerves: correlation between US and histologic findings and criteria to differentiate tendons. Radiology 1995;197:291–6.
Fornage BD. Peripheral nerves of the extremities: imaging with US. Radiology 1988;167:179–82.
Olszewski J. Variations of the pudendal nerve in man. Folia Morphol (Warsz.) 1982;41:245–52.
Sikorski A, Olszewski J, Miekos E. Anatomical considerations of selective pudendal neurectomy. Int Urol Nephrol 1987;19:159–63.
O'Bichere A, Green C, Phillips RK. New, simple approach for maximal pudendal nerve exposure: anomalies and prospects for functional reconstruction. Dis Colon Rectum 2000;43:956–60.
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Kovacs, P., Gruber, H., Piegger, J. et al. New, simple, ultrasound-guided infiltration of the pudendal nerve. Dis Colon Rectum 44, 1381–1385 (2001). https://doi.org/10.1007/BF02234802
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DOI: https://doi.org/10.1007/BF02234802