Pudendal Nerve Identified on Sectioned Images of Female Cadaveric Pelvis


      To provide an anatomical atlas made of serially sectioned images of a female cadaver that clearly demonstrated the pudendal nerve.

      Materials and Methods

      The courses of the pudendal nerve, internal pudendal artery, and internal pudendal vein were observed on the sectioned images of a female cadaver. The spatial relationship between the nerve and blood vessels was interpreted.


      Traces of the structures on the sectioned images showed that the sources of the sciatic and pudendal nerves were the fourth lumbar nerve to the second sacral nerve and the second to the fourth sacral nerves, respectively. As the borderline, the second sacral nerve showed a remarkable variation. The pudendal nerve gave off the internal rectal nerve proximal to the pudendal canal and it gave off the muscular branch to the urogenital triangle in the pudendal canal. It was divided into the posterior labial nerve and the dorsal nerve of clitoris distal to the pudendal canal. Inside the pudendal canal, the internal pudendal vein, internal pudendal artery, and pudendal nerve were arranged from superomedial to inferolateral order. In other words, the pudendal nerve was the farthest from the uterus.


      The sorted sectioned images with labels, accompanied by the schematic drawings, could serve as references for interpreting clinical images and conducting procedures related to pudendal nerve conditions.
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        • Filler AG
        Diagnosis and treatment of pudendal nerve entrapment syndrome subtypes: imaging, injections, and minimal access surgery.
        Neurosurg Focus. 2009; 26: E9
        • Robert R
        • Prat-Pradal D
        • Labat JJ
        • et al.
        Anatomic basis of chronic perineal pain: role of the pudendal nerve.
        Surg Radiol Anat. 1998; 20: 93-98
        • Labat JJ
        • Riant T
        • Robert R
        • et al.
        Diagnostic criteria for pudendal neuralgia by pudendal nerve entrapment (Nantes criteria).
        Neurourol Urodynam. 2008; 27: 306-310
        • Antolak Jr SO
        • Hough DM
        • Pawlina W
        • et al.
        Anatomical basis of chronic pelvic pain syndrome: the ischial spine and pudendal nerve entrapment.
        Med Hypotheses. 2020; 59: 349-353
        • Schmidt RA
        Technique of pudendal nerve localization for block or stimulation.
        J Urol. 1989; 142: 1528-1531
        • Kovacs P
        • Gruber H
        • Piegger J
        • et al.
        New, simple, ultrasound-guided infiltration of the pudendal nerve.
        Dis Colon Rectum. 2001; 44: 1381-1385
        • Hough DM
        • Wittenberg KH
        • Pawlina W
        • et al.
        Chronic perineal pain caused by pudendal nerve entrapment: anatomy and CT-guided perineural injection technique.
        Am J Roentgenol. 2003; 181: 561-567
        • Rofaeel A
        • Peng P
        • Louis I
        • et al.
        Feasibility of real-time ultrasound for pudendal nerve block in patients with chronic perineal pain.
        Reg Anesth Pain Med. 2008; 33: 139-145
        • Robert R
        • Labat JJ
        • Bensignor M
        • et al.
        Decompression and transposition of the pudendal nerve in pudendal neuralgia: a randomized controlled trial and long-term evaluation.
        Eur Urol. 2005; 47: 403-408
        • Anderson D
        Pudendal nerve block for vaginal birth.
        J Midwifery Womens Health. 2014; 59: 651-659
        • Schraffordt SE
        • Tjandra JJ
        • Eizenberg N
        • et al.
        Anatomy of the pudendal nerve and its terminal branches: a cadaver study.
        ANZ J Surg. 2004; 74: 23-26
        • Shafik A
        • El‐Sherif M
        • Youssef A
        • et al.
        Surgical anatomy of the pudendal nerve and its clinical implications.
        Clin Anat. 1995; 8: 110-115
        • Lufkin R
        • Rauschning W
        • Seeger L
        • et al.
        Anatomic correlation of cadaver cryomicrotomy with magnetic resonance imaging.
        Surg Radiol Anat. 1987; 9: 299-302
        • Park JS
        • Chung MS
        • Shin DS
        • et al.
        Sectioned images of the cadaver head including the brain and correspondences with ultrahigh field 7.0 T MRIs.
        Proc IEEE. 2009; 97: 1988-1996
        • Park HS
        • Choi DH
        • Park JS
        Improved sectioned images and surface models of the whole female body.
        Int J Morphol. 2015; 33: 1323-1332
        • Agur AM
        • Dalley AF
        Moore's Essential Clinical Anatomy.
        6th ed. Wolters Kluwer Health, Philadelphia, PA2018
        • Labat JJ
        • Riant T
        • Lassaux A
        • et al.
        Adding corticosteroids to the pudendal nerve block for pudendal neuralgia: a randomised, double‐blind, controlled trial.
        BJOG. 2017; 124: 251-260
        • Mahakkanukrauh P
        • Surin P
        • Vaidhayakarn P
        Anatomical study of the pudendal nerve adjacent to the sacrospinous ligament.
        Clin Anat. 2005; 18: 200-205
        • Gavrilov SG
        Vulvar varicosities: diagnosis, treatment, and prevention.
        Int J Womens Health. 2017; 9: 463
        • Silbert PL
        • Dunne JW
        • Edis RH
        • et al.
        Bicycling induced pudendal nerve pressure neuropathy.
        Clin Exp Neurol. 1991; 28: 191-196
        • Park JS
        • Chung MS
        • Hwang SB
        • et al.
        Technical report on semiautomatic segmentation using the Adobe Photoshop.
        J Digit Imaging. 2005; 18: 333-343
        • Shin DS
        • Jang HG
        • Hwang SB
        • et al.
        Two‐dimensional sectioned images and three‐dimensional surface models for learning the anatomy of the female pelvis.
        Anat Sci Educ. 2013; 6: 316-323
        • Chung BS
        • Chung MS
        Four learning tools of the Visible Korean contributing to virtual anatomy.
        Surg Radiol Anat. 2019; 41: 1211-1216
        • Cho ZH
        7.0 Tesla MRI Brain Atlas: In Vivo Atlas With Cryomacrotome Correlation.
        Springer Science & Business Media, Berlin, Germany2010