Pudendal Nerve and Pudendal Neuralgia

The pudendal nerve originates from the sacral plexus (S2-S4). It has both sensory and motor fibres.

The sensory pudendal nerve branches into 3 smaller nerves:

• Inferior rectal nerve
• Perineal nerve (which supplies the perineum, vagina, scrotum, labia, and urethra)
• Dorsal nerve of the clitoris or penis.

The motor branch of the nerve supplies the external anal sphincter, sphincter muscles of the bladder, and the muscles of the pelvic floor.

Pudendal neuralgia is irritation of the pudendal nerve. A common site for pudendal nerve irritation may be at the Alcock’s Canal and/or at the obturator internus muscle. Pudendal neuralgia can occur in men and women.

Common Signs and symptoms of pudendal neuralgia may include the following:

• Pelvic pain with sitting, but improvement with standing or sitting on a toilet seat
• Burning, stabbing pain in the vagina, labia, clitoris, penis, scrotum, perineum, anus, and rectum
• Tailbone pain
• Feeling of foreign object in vagina and/or rectum
• Urinary, bowel and/or sexual dysfunction
• Discomfort with tight clothing like jeans, pants, panty hose