Atrapamiento del nervio pudendo: Un síndrome por conocer

Abstract

The pudendal nerve entrapment syndrome was first described in 1987. The main complaint for consultation is pain, mainly located at the perineal and/or pelvic area; which can be associated to urinary, anal and even sexual dysfunction. The three main pudendal terminal branches contain motor, sensitive and autonomic fibers; this explains the diversity of signs and symptoms. 70% of nervous fibers are somatic (sensitive 50% and 20% motor), and the rest autonomic (30%). The classic pain is described as perineal, worsens when seating, diminishes or disappears when standing, usually absent when lying down and it does not interfere with night rest. The diagnosis can be entertained when two major criteria or one major and two minor are present simultaneously according the punctuation score mentioned. The treatment should always be sequential and includes three main steps. The stage 1 is autoprotection (perineal, avoidance of sitting, climbing, etc), stage 2 is based in pudendal nerve perineural injections (anesthetics and corticosteroids) and stage 3 implies decompression surgery of the pudendal nerve.