![]() The pudendal nerve originates in the sacral plexus it derives its fibers from the ventral rami of the second, third and fourth sacral nerves. The relevant anatomy, etiopathogenesis and management are discussed, and suggestions are made for its prevention. Excessive and/or prolonged traction against the perineal post of a traction table, leading to direct compression and localized ischemia to the nerve are the main contributing factors of injury. Keywords: Erectile dysfunction Pudendal nerve Injury Orthopedic surgery IntroductionĮrectile dysfunction (ED) resulting from direct damage of pudendal nerve involved following orthopedic surgery is not uncommon it can have serious medico-legal implications in addition being a distressful event for the patients. Patients must be clearly informed about this possible neurological complication before an operation on the orthopedic table. Preventive measures should be considered by surgeons to avoid perineal traction injuries. Pudendal nerve decompression was reported to be useful in some cases. No medical treatment has demonstrated its effectiveness. Electrophysiological examinations should be considered when symptoms are not regressive and in cases of vesico-sphincter dysfunction and immediate severe ED. Urinary incontinence, ED and hypoesthesia or complete anesthesia of scrotum and glans penis are the main clinical manifestations. Clinical signs are essentially sensitive, such as hypoesthesia of the perineum. Prolonged countertraction on the fracture table and the inappropriate placement of the perineal post are the two main contributing factors. Erectile dysfunction (ED) resulting from direct damage of pudendal nerve injury during orthopedic surgery is common and closely associated to the use of traction tables. ![]()
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