Chronic Perineal Pain Caused by Pudendal Nerve Entrapment: Anatomy and CT-Guided Perineural Injection Technique

Zetocha²,

Journal of Chiropractic Medicine

2016

Objective: The purpose of this case report is to describe the chiropractic management of a patient with postoperative perineal numbness as a result of hip arthroscopy. Clinical Features: A female patient presented to a chiropractic clinic with 7 weeks of ongoing perineal numbness after right hip arthroscopic surgery with labral repair. The patient reported lack of sensation during urination, sexual intercourse, and the insertion and removal of female hygienic products into the vagina. Intervention and Outcome: Conservative care included myofascial therapy to the psoas and obturator internus muscles and instrument-assisted soft tissue mobilization over the obturator internus. Manual manipulation to the pelvis was also performed. The patient reported complete resolution of perineal numbness after 3 chiropractic treatments. Conclusion: With conservative chiropractic management, full resolution of sensation for this patient was achieved. (J Chiropr Med 2016;15:305-309)

Section: Discussionmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

Chiropractic Management of a Patient With Perineal Numbness After Arthroscopic Hip Surgery: A Case Report

Zetocha²,

Journal of Chiropractic Medicine

2016

“…Symptoms of pain usually resolve quickly, while those that are sensory in nature tend to last longer and can accompany sexual disorders as well. Anatomically, the obturator internus is a common entrapment site of the pudendal nerve due to muscular spasms [13,14].…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and Conservative Chiropractic Care of Chronic Idiopat hic Pudendal Nerve Entrapment Causing Saddle-Like Paresthesia and Restless Genital Syndrome: A Case Study

Olson¹

2016

J Spine

“…5 It is seen mostly in men 6 and is inconclusive about occupational or special stress. 7 Fibroblasts cells are present in large number in ligamentous tissue and are reported to be linked with heterotopic ossification in ligaments. However, the proper mechanism by which fibroblasts mediate this remains uncertain.…”

Section: Case Reportmentioning

confidence: 99%

“…7 An ossified STL may act as a lobster claw and with a restricted anatomical space may compress the pudendal nerve clinically producing the entrapment syndrome causing chronic perineal pain or loss of sensation. 12 It may also compress inferior gluteal artery branches and result in ischemia of area supplied.…”

mentioning

confidence: 99%

Indiscriminate ossification of ligaments in a dry adult human male pelvisâ€“ A rarity

2020

IJCAP

Introduction: Human pelvis exhibits sacrotuberous, sacrospinous and transverse acetabular ligament performing the function of stabilisation of pelvis and hip joint respectively. The ossification of this ligaments has been reported solitary and rarely in composite. Materials and Methods: During undergraduate osteology teaching authors noticed a dry human male pelvis demonstrating compounded ossification of ligaments and bony distortions. Case Report: The left sacrotuberous ligament was partially ossified and demonstrated triangular anteroinferior and posterosuperior segments. The transverse acetabular ligament of right side was totally ossified and left was partially ossified. A bony mass was observed at the left ala of sacrum with fusion of pedicle and left lower part of body of fifth lumbar vertebra and ala of sacrum. Bilateral sharp bony spicules at iliopectineal lines and exostosis at bilateral iliac tuberosity was noticed. Conclusion: This exhibit brings out an unreported rare anatomical variant of bony pelvis, the knowledge of which will be of paramount importance to radiologists and orthopaedic surgeons.