ABSTRACT

The objective of this work is to localize pudendal nerve compression by measuring sacral reflexes and to explain differences in latencies by an anatomical investigation. Electrophysiological data was obtained from 59 patients by measuring the healthy side and the painfull side of 79 patients with uni- or bilateral pain. In addition, 7 formalin-fixed female cadavers were dissected to identify nerve trajectories. Dissections demonstrated that the levator ani nerve runs directly from the sacral plexus, to innervate the levator ani, while the pudendal nerve traverses the sacrospinal and sacrotuberal ligaments, entering the perineum with an inferior rectal nerve, already separated runs to the posterior or caudal part of the external anal sphincter muscle, while the anterior parts of the external anal sphincter muscle are innervated by perineal nerve branches coming from the pudendal canal. Significant differences in latencies suggest that main nerve compression occurs in the pudendal canal. In conclusion, it is possible to localize differences in pudendal nerve compression by separate electrophysiological examination of staged sacral reflexes and allows to narrow down the location of nerve compression.