The woman, named only as Maria, 61, from Dunbartonshire, says it started after a smear test at Stobhill Hospital, Glasgow, in 2017, when a consultant "rammed" a speculum in, damaging her
pudendal nerve.
The internal
pudendal artery supplies two main
pudendal flaps: The Singapore and lotus petal flaps.
The
pudendal nerves supply the penis and the clitoris, as well other areas of the genital skin and musculature (Martin-Alguacil, Schober, Sengelaub, Pfaff, & Shelley, 2008).
Pudendal neuralgia is a painful, neuropathic condition involving the dermatoma of the
pudendal nerve.[1] Firstly defined by Amarenco et al.,[2] this condition was described with a neuropathic pain emerging in the form of burning on the
pudendal nerve distribution.
Although the rate of perineal wound infections has been reduced with the aid of flaps,[6] several studies have reported that ELAPE may increase postoperative perineal morbidity such as chronic perineal pain, perineal wound infection, urinary retention, perineal herniation, and sexual dysfunction.[2],[3],[4],[7],[8],[9] In particular, chronic pain may be related to the coccygectomy, damage to the
pudendal nerve, the wider excision of the levator ani muscles, and/or the suturing of the biological mesh close to the pelvic wall.[4],[9]
(40), who successfully demonstrated the restoration of the urethral sphincter in a
pudendal nerve-transected rat following the injection of muscle-based stem cells.
A Cobra catheter was passed into the contralateral right internal iliac artery, where digital subtraction angiography (DSA) demonstrated two areas of active contrast extravasation from the presumed internal
pudendal and obturator arteries, compatible with hemorrhage secondary to traumatic lacerations (Figure 1b).
The arteries are the umbilical (obliterated), uterine, superior vesical, vaginal, obturator, middle rectal, internal
pudendal, and inferior gluteal arteries (2).
The
pudendal block was applied before any anal examination.
"Injury during childbirth, which can be related to tears, failure to heal from episiotomy wounds, injury to pelvic floor muscles through forceps delivery or
pudendal nerve injuries, may be identified at the time of delivery and where appropriate repaired, but some of these may be missed.
In another case, a patient who had Peyronie's disease was treated with penile reconstruction using a de-epithelialized Belman (superficial external
pudendal artery) flap and the result was well (18).
A 10-year-old girl visited our affiliated hospital, complaining of
pudendal deformity.