Entrapment Neuropathy of the Internal Pudendal Nerve: Report of two cases

Abstract

Entrapment neuropathy of the internal pudendal nerve in the Alcock canal is a rare entity and literature on the subject is lacking. The pathogenesis of this disease is probably related to repeated microtraumatisms of the perineal region acting on the Alcock canal or dysmetabolic diseases favouring compression of the pudendal nerve inside the Alcock canal. In this article two new cases which have come to our attention are described and literature on the topic, with special regard to diagnosis and treatment, is reviewed.

Pudendal Nerve Entrapment as Source of Intractable Perineal Pain

“…A relationship is recognized between burning pain and prolonged mechanical compression of the pudendal nerve within the pudendal canal shortly before symptoms begin. 21 Bicyclists, both professional and amateur, seem to be at increased risk of developing the syndrome, presumably due to chronic perineal microtrauma and resulting inflammation or fibrosis in the pudendal canal and the sacrotuberous/sacrospinous ligaments.…”

Is Sacral Nerve Stimulation an Effective Treatment for Chronic Idiopathic Anal Pain?

“…11 Furthermore, pudendal nerve entrapment in Alcock's canal (Alcock's canal syndrome) has also been suggested when chronic perianal pain occurs unilaterally and pudendal nerve terminal motor latency is prolonged only on that side. 12 However, surgical decompression of the nerve rarely relieves the symptoms. 1 The contribution of psychologic factors should also be taken into consideration.…”

Proctalgia in Pudendal Nerve Entrapment Syndrome: A Pathology to Know

“…Other processes associated with the syndrome are perineal injuries [7], pelvic radiotherapy, rectal prolapse, etc., although none of these were present in our sample.…”

“…Causes associated with this entrapment are: professional/ sports activities that involve the sitting position [5,6], perineal injuries [7], gynecological causes [8][9][10], pelvis radiotherapy, rectal prolapse [11][12][13].…”