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Anatomy of the Anterior Abdominal Wall
Published in Jeff Garner, Dominic Slade, Manual of Complex Abdominal Wall Reconstruction, 2020
Inferiorly the pelvic cavity is separated from the ischio-rectal fossa and perineum by the levator ani muscle. The levator ani is attached in a continuous line along the posterior aspect of the pubis, across the fascia of the obturator internus muscle as far as the spine of the ischium. The fibres pass down, medially and posteriorly, to form a bowl, and are inserted into a midline raphe, the coccyx and lower sacrum. Posteriorly there is a free edge of muscle extending from the spine of the ilium to the sacrum. Posterior to the free edge is the greater sciatic foramen which is almost completely filled by the piriformis muscle.
Anatomy
Published in J. Richard Smith, Giuseppe Del Priore, Robert L. Coleman, John M. Monaghan, An Atlas of Gynecologic Oncology, 2018
Ernest F. Talarico, Jalid Sehouli, Giuseppe Del Priore, Werner Lichtenegger
The internal pudendal artery will course inferolaterally and exit along the inferior border of the piriformis muscle in the greater sciatic foramen. Then, it will pass around the ischial spine (or sacrospinous ligament), re-entering the pelvis through the lesser sciatic foramen. It exits near the pudendal canal giving rise to the perineal artery and the dorsal artery of the clitoris.
General Surgery
Published in Kaji Sritharan, Samia Ijaz, Neil Russell, Tim Allen-Mersh, 300 Essentials SBAs in Surgery, 2017
Kaji Sritharan, Samia Ijaz, Neil Russell, Tim Allen-Mersh
A sciatic hernia passes through: The lesser sciatic foramenThe greater sciatic foramenThe obturator canalThe arcuate line into the lateral border of the posterior rectus sheathThe inferior lumbar triangle
Diagnosis and treatment of pudendal and inferior cluneal nerve entrapment syndrome: a narrative review
Published in Acta Chirurgica Belgica, 2022
Katleen Jottard, Pierre Bonnet, Viviane Thill, Stephane Ploteau, Stefan de Wachter
The PN has been referred to as the king of the perineum [3]. Indeed, the PN plays a major role in the fecal and urinary continence mechanisms and is important for normal sexual functioning. The PN has both motor and sensory functions and carries sympathetic fibers. It arises from the second, third, and fourth sacral ventral rami at the inferior edge of the piriformis muscle [4]. Before entering the gluteal region, the nerve passes through the infrapiriformis foramen, which is a part of the greater sciatic foramen. The nerve then passes posterior from the ischial spine or sacrospinous ligament (SSL), medial to the internal pudendal vessels, to finally enter the perineum through the Alcock’s canal, a fold of the obturator internus muscle fascia. It continues to course through the pudendal canal (Alcock’s canal), giving off three consecutive branches on its path: the inferior rectal (anal) nerve and its branches, the perineal nerve and its branches and the dorsal nerve of the penis or clitoris.
Clinical effect of computed guided pudendal nerve block for patients with premature ejaculation: a pilot study
Published in Scandinavian Journal of Urology, 2020
Fouad Aoun, Georges Mjaess, Joseph Assaf, Anthony Kallas Chemaly, Tonine Younan, Simone Albisinni, Fabienne Absil, Thierry Roumeguère, Renaud Bollens
Anatomically, the pudendal nerve is a branch of the sacral plexus [19–21]. It emerges from the S2, S3 and S4 roots, then departs the pelvis from the greater sciatic foramen along with the sciatic roots, between the sacrospinal and the sacrotuberous ligament, and re-enters the pelvis via the lesser sciatic foramen [19–21]. At this level, it releases a superior hemorroidal branch and then cruises through a duplication of the obturator muscle’s fascia called ‘Alcock’s canal’. The pudendal nerve gives rise at the exit of Alcock’s canal to three main branches which are the inferior rectal branch, the perineal branch and the dorsal sensory nerve of the penis or clitoris [19–21]. The pudendal nerve entrapment consists of a compression of this nerve especially between sacrospinous and sacrotuberous ligaments (which constitutes the most common level of entrapment) or in Alcock’s canal [19–21].
The Role of Pudendal Nerve Block in Colorectal Surgery: A Systematic Review
Published in Journal of Investigative Surgery, 2021
Michael G. Fadel, Laura Peltola, Gianluca Pellino, Gabriela Frunza, Christos Kontovounisios
The pudendal nerve is a mixed sensory and motor nerve that arises from S2, S3 and S4 nerve roots in the sacral plexus [1]. It exits the pelvis through the greater sciatic foramen and reenters the perineum to course through the ischiorectal fossa and Alcock’s canal. Here, the pudendal nerve accompanies the pudendal blood vessels and divides into three branches: inferior rectal nerve, perineal nerve, and the dorsal nerve of the clitoris or penis. The pudendal nerve provides innervation to the urethral muscles, clitoris, penis, perineum and pelvic floor sphincter, urethra and bladder triangle [2, 3].