Pudendal nerve

The pudendal nerve is the main nerve of the perineum.

The term pudendal comes from Latin pudenda, meaning external genitals, derived from pudendum, meaning “parts to be ashamed of”.

The pudendal canal is also known by the eponymous term “Alcock's canal”, after Benjamin Alcock, an Irish anatomist who documented the canal in 1836. Alcock documented the existence of the canal and pudendal nerve in a contribution about iliac arteries in Robert Bentley Todd's “The Cyclopaedia of Anatomy and Physiology” 1).

It carries sensation from the external genitalia of both sexes and the skin around the anus and perineum, as well the motor supply to various pelvic muscles, including the male or female external urethral sphincter and the external anal sphincter. If damaged, most commonly by childbirth, lesions may cause sensory loss or fecal incontinence. The nerve may also be temporarily blocked as part of an anaesthetic procedure.

The pudendal canal is also known by the eponymous term “Alcock's canal”, after Benjamin Alcock, an Irish anatomist who documented the canal in 1836.

Laparoscopic implantation of neuromodulation electrodes allows simultaneous stimulation of S3 and pudendal nerves, providing more programming options and possibly increasing success rates in complex pelvic floor dysfunction cases 2).


Pudendal nerve afferents are a promising target to restore lost bladder control, as stimulation with different frequencies may be used to treat urinary incontinence and increase continent volumes or to generate stimulation-evoked bladder contractions for on-demand voiding. This work identified that co-stimulation of multiple afferent reflex pathways can enhance activation of spinal circuits and may enable improved bladder emptying in SCI when stimulation of a single pathway is not sufficient 3).

Pudendal neuralgia

Pudendal neuralgia

2)
Li ALK, Marques R, Oliveira A, Veloso L, Girão MJBC, Lemos N. Laparoscopic implantation of electrodes for bilateral neuromodulation of the pudendal nerves and S3 nerve roots for treating pelvic pain and voiding dysfunction. Int Urogynecol J. 2017 Jul 15. doi: 10.1007/s00192-017-3411-7. [Epub ahead of print] PubMed PMID: 28712018.
3)
McGee MJ, Swan BD, Danziger ZC, Amundsen CL, Grill WM. Multiple Reflex Pathways Contribute to Bladder Activation by Intraurethral Stimulation in Persons with Spinal Cord Injury. Urology. 2017 Aug 8. pii: S0090-4295(17)30791-4. doi: 10.1016/j.urology.2017.07.041. [Epub ahead of print] PubMed PMID: 28801220.