Anatomical Variation of the Pudendal Nerve and Related Structures

Area of Science:

• Neuroanatomy
• Pelvic Anatomy
• Surgical Anatomy

Background:

• The pudendal nerve (PN) typically originates from sacral roots S2-S4.
• Conditions like pudendal neuralgia show significant clinical variability.
• Anatomical variations of the PN may underlie this variability by creating vulnerable nerve positions.

Purpose of the Study:

• To conduct a scoping review of anatomical variations of the pudendal nerve and associated structures.
• To understand the role of PN anatomical diversity in pathophysiology and clinical outcomes.

Main Methods:

• Scoping review conducted following PRISMA-ScR guidelines.
• Searches performed in MEDLINE and EMBASE databases.
• Included human anatomical investigations of PN variations, irrespective of methodology.

Main Results:

• Substantial anatomical diversity identified in PN roots, trunk, and branches.
• Detailed schematic illustrations of variations were developed.
• Limitations include methodological heterogeneity and reliance on cadaveric specimens.

Conclusions:

• Anatomical variation is a significant factor in PN-related conditions.
• Understanding PN variability is critical for diagnosis, surgical planning, and management.
• This review provides context for refining decompression techniques and therapeutic strategies.