Pudendal Nerve Entrapment
Pudendal nerve entrapment (PNE) is a source of chronic pain, in which the pudendal nerve (located in the pelvis) is entrapped or compressed. Pain is worsened by sitting, and can include prickling, stabbing, burning, numbness, and the sense of a foreign object in the urethra, vagina, or rectum. In addition to pain, symptoms can include sexual dysfunction, impotence, anal and urinary incontinence.
The Pudendal Nerve is located between 2 ligaments in the pelvic floor. The top ligament is called sacrotuberous ligament (ST) and the bottom ligament is called sacrospinous ligament (SS). The cause of Pudendal Nerve Entrapment is sometimes unknown and other times some patients can pinpoint the exact activity that occurred when the pain struck for the first time. It can be caused by prolonged sitting, a trauma, heavy lifting, surgery and one hypothesis is that the patient is predisposed to PNE and something can happen to trigger it.
PNE can be caused by pregnancy, scarring due to surgery and accidents. Anatomic abnormalities can result in PNE due to the pudendal nerve being fused to different parts of the anatomy, or trapped between the sacrotuberous and sacrospinalis ligaments. Heavy and prolonged bicycling, especially if an inappropriately shaped or incorrectly positioned bicycle seat is used, may eventually thicken the sacrotuberous and/or sacrospinous ligaments and trap the nerve between them, resulting in PNE.
Symptoms Of Pudendal Nerve Entrapment
The most common type of pain is a burning sensation. Other type of pain often experienced are: twisting, pulling sensations, electric shock sensations, vague pains, stabbing pains, pin pricking, numbness and cold sensations. The pain level can vary from time to time but the nature of the pain is constant. The pain can move around to different areas.