Aspectos anatómicos y topográficos del nervio pudendo en la región glútea

Abstract

The pudendal nerve distributes motor and sensory branches to the perineum and genital external organs. It has functional importance in the micturition, defecation, erection and labor. From the clinical point of view, anaesthetic blockade of the same one is realized in the obstetric practice, electroestimulation in cases of fecal or urinary incontinence, among other procedures. Anatomical investigations have indicated that it can present variations in its conformation and topography. The objective of this study was complete knowledge about this nerve in its course through the gluteal region, its conformation, biometry and its relationship with the internal pudendal vessels and adjacent ligaments were studied. We dissected 30 gluteal regions of 15 corpses fixed in formaldehyde 10% of Brazilian individuals, adult, of both sexes, observing the conformation of the nerve, number of branches, disposition with regard to the internal pudendal vessels and sacrotuberous and sacrospinous ligaments, also recording its external diameter in the distance between greater sciatic foramen and lesser sciatic foramen. The pudendal nerve appeared as a single trunk in 53.3% of the cases and divided in branches in 46.7% (two branches in 36.7%, three in 6.7% and four in 3.3%). When it was divided, in 36,7% the branches remained separated and in 10% they joined before the lesser sciatic foramen. The nerve (single or divided) was medial to the internal pudendal vessels in 70% and lateral to them in 3.3%. In 26.7%, it was divided in two or three branches, which were located medially and laterally to these vessels or crossing posterior to them. Its position was anterior to the sacrotuberous ligament in 93.3%. The pudendal nerve presents interesting variations in its conformation and topography which must be considered during the clinical and surgical procedures.