Intra-abdominal laparoscopic pudendal canal decompression - a feasibility study

Area of Science:

• Surgical anatomy
• Minimally invasive surgery
• Pelvic anatomy

Background:

• Pudendal canal syndrome (PCS) results from compression or stretching of the pudendal nerve within Alcock's canal.
• Current surgical approaches for PCS have limitations and potential complications.

Purpose of the Study:

• To evaluate the feasibility of intra-abdominal laparoscopic pudendal canal decompression (ILPCD) as a treatment for PCS.
• To assess the anatomical suitability of the intra-abdominal approach in cadavers.

Main Methods:

• The study utilized 30 male adult human cadavers to examine the intra-abdominal laparoscopic pudendal canal decompression (ILPCD) technique.
• Key anatomical landmarks and working space dimensions were measured during the laparoscopic procedure.

Main Results:

• An adequate working space (mean 24 mm) was achieved in 80% of the cadavers.
• Anatomic signs of pudendal nerve compression consistent with PCS were identified in 35% of specimens.
• The technique allowed clear visualization of the pudendal canal and its contents via laparoscopic guidance.

Conclusions:

• Intra-abdominal laparoscopic pudendal canal decompression (ILPCD) is a theoretically viable option for reducing pudendal nerve stretching in PCS.
• The study highlights the potential of ILPCD to address limitations of existing surgical methods for PCS.