Pudendal Nerve

NEURAL PATHWAY

The pudendal nerve originates from the ventral rami of the S2-S4 spinal roots.

Ventral divisions of S2-S4 → Sacral Plexus → Pudendal Nerve

Anatomical path of pudendal nerve (source)
Anatomical path of pudendal nerve (source)

This nerve gives rise to the inferior rectal nerve

FUNCTION

This nerve provides motor and sensory innervation to the perineal region of the body.

Sensory branches innervate the external genitalia as fellas the skin around the anus and perineum.

Source

Motor branches innervate the pelvic floor muscles, as well the external urethral and anal sphincters.

CAUSE OF INJURY

Stretch injury can commonly affect this nerve because of its curved course around the ischial spine. The following scenarios are associated with pudendal nerve injury.

  • Active pushing during prolonged labor can cause damage to the nerve.
CLINICAL PRESNENTATION

Patients may present with the following complaints that are associated with pudendal nerve damage.  

  • Fecal incontinence
  • Urinary incontinence 
  • Perineal pain
  • Sexual dysfunction

Physical exam can reveal:

  • Decreased/absent anal wink reflex
  • Decreased anal sphincter tone

 

Page Updated: 07.31.2016