The Pudendal Nerve

What and Where is the Pudendal Nerve?

The pudendal nerve is a major peripheral nerve in your pelvic region. The peripheral

nervous system refers to parts of the nervous system outside the brain and spinal cord.

The pudendal nerve is formed from the sacral plexus – a network of nerve fibers located

on the posterior (back) pelvic wall. It arises from the ventral rami (anterior divisions) of

the Sacram sacral spinal nerve roots S2, S3 and S4. The sacram is directly below the

lumbar vertebrae (L1 to L5) of your spine.

After re-entering the pelvis, it accompanies the internal pudendal artery and vein,

coursing anterosuperiorly (in front and above) through the pudendal canal (also known

as Alcock’s canal) where the pudendal nerve divides into three branches:

Inferior Rectal nerve (back) – innervates (to supply nerves to the perianal skin and lower third of the anal canal.
Perineal nerve (middle) – innervates (to supply nerves to) the skin of the perineum, labia minora, majora or posterior scrotum.
Dorsal nerve (front) of the clitoris or penis – innervates (to supply nerves to) the skin of the penis or clitoris. Thus, responsible for carrying information from sensory receptors of the skin and other organs of clitoral and penile erection.

Perineal View of human anatomy showing all three

branches which first divide Pudendal Canal also

known as Alcock's Canal (not included in this diagram)

at the first "1." Rectal branch.

Anterior View or front view of human

anatomy showing the location of the

pudendal nerve in the pelvis.

It's CRITICAL to remember that this nerve sends sensory and movement (motor) signals

from your genital area to your spinal cord then to your brain.

Sensory Function

The pudendal nerve supplies sensation to external genitalia of both sexes through its three branches to the skin around the anus, anal canal and perineum, dorsal (clitoris and penis).

Motor Functions

Motor Functions – innervates various pelvic muscles, the external urethral sphincter and the external anal sphincter. Therefore, the pudendal nerve provides the voluntary/somatic control of urinary and fecal continence. If a doctor cuts or ablates (destroys) the pudendal nerve, the individual would suffer permanent urinary and fecal continence. They would be forced to use a catheter and urinary bag and have a colostomy surgery and colostomy bag attached for the rest of their life. This would be medically unethical and unacceptable.

This is why pudendal neuralgia, unlike other nerve pain, is so difficult to treat and cure. However, because the pain is so severe, we cannot let this challenge stop us from continuing research, clinical trials, and double-blind studies as we do with all other challenging diseases that devastate people's lives. We must never give up until we find a cure as with Alzheimer's, Huntington's disease., muscular dystrophy, multiple sclerosis, etc.

A Lateral View of the pudendal

nerve showing the first division.

inside the Pudendal or Alcock's

canal, into its three branches.

Figures By TeachMeSeries Ltd (2023)

Pudendal Neuralgia Alliances (PNA) conjects these numbers might be higher because many Americans are not included in the official statistics:

People without insurance or underinsured with high-deductibles who can't afford care
Those living in poverty with more than one job and no transportation or childcare
Continuing disparities of care quality between white people and people of color
Populations in rural areas with no medical providers
Fewer men seek help for medical problems than women
Shame and embarrassment because this is a condition of the human genitals may keep people from seeking help

Because Pudendal Neuralgia is a rare condition, there are few specialists with extensive experience in the United States who treat the condition. Sadly, more and more of these doctors are moving to cash-only business models which make them prohibitively expensive for most Americans when once thinks of the cost of implanting a medical stimulator device or a surgery. The costs run well over $10,000 and most people must travel by car or air. to find a doctor.

1 What Is Chronic Pain Management? Symptoms and Reasons to Control Chronic Pain (webmd.com)

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Pudendal Neuralgia Alliance

contact@pudendalneuralgiaalliance.org

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