Technique of pudendal nerve localization for block or stimulation

Area of Science:

• Neurology
• Urology
• Anatomy

Background:

• The pudendal nerve (PN) plays a crucial role in pelvic floor function and continence.
• Accurate diagnostic techniques are essential for evaluating PN integrity and associated disorders.
• Current methods may have limitations in precise localization and functional assessment.

Purpose of the Study:

• To describe a novel diagnostic technique for studying the pudendal nerve (PN).
• To evaluate the advantages of a dorsal approach for PN assessment compared to traditional perineal methods.
• To enable accurate urodynamic evaluation of sphincteric function and pelvic floor striated muscles.

Main Methods:

• A dorsal approach with the patient in the prone position and slight hip flexion.
• Topographical identification of the ischial spine using anatomical landmarks.
• Use of local anesthesia and electrical stimulation for precise needle placement adjacent to the PN.
• Continuous urodynamic monitoring during PN stimulation.

Main Results:

• The described technique allows for specific localization of the pudendal nerve (PN).
• Facilitates accurate temporary or permanent nerve blocks.
• Enables continuous urodynamic monitoring of pelvic floor behavior.
• Assesses the functional integrity of the PN and pelvic floor striated muscles.

Conclusions:

• The dorsal approach offers unique advantages for pudendal nerve (PN) study.
• This technique improves diagnostic accuracy for sphincteric dysfunction.
• It provides a comprehensive method for assessing PN and pelvic floor integrity.