Attention to Pudental Nerve Injury as a Result of Falling in Snow!

Pudental syndrome due to trauma in the pudendal nerve as a result of the fall is a situation that should be paid attention in the winter days when the places are covered with ice. Because the beginning of the disturbances affecting many systems, from the genital area to the urinary tract and the anus, can only begin with a fall on the hip.



The accident starts with a pain similar to an electric shock or a sudden pain with pudendal syndrome after a fall or an opposite movement. Generally, the complaints begin suddenly after falling, but sometimes they may develop slowly over time.
 

What are the symptoms of pudental syndrome?

The most common symptom due to pudental neuralgia and pudendal nerve compression is pain. Pain occurs in areas where the pudendal nerve and its branches are attached. These regions are rectum, anus, urethra, perineum, clitoris, external sexual region, 1/3 of the vagina. 2/3 of the patients are women. Penile and erectile glands are affected in men. Pain increases as you sit. Touch or pressure-induced hypersensitivity develops in the skin tissue. The most common symptoms in these regions are:
  • Burning
  • Electric shock sensation
  • Faintness
  • Pain like a knife cut
  • Pain
  • A feeling of pressure as if there is a foreign body in the vagina or rectum
  • Abnormal temperature sensation
  • Throbbing with bowel movements
  • Burning while urinating
  • Painful sexual intercourse
  • Continuous genital arousal syndrome, even if the person does not want
  • Pain after orgasm
  • Numbness
 

On what conditions can pudendal syndrome occur, except falls?

  • Trauma to childbirth,
  • Damage during surgery;
  • Continuous repetitive mechanical compression in cycling athletes,
  • Diabetes that causes peripheral neuropathy, diseases that cause vasculitis,
  • It develops depending on the compressive nerve.
 

How is the diagnosis made in pudental syndrome?

Diagnosis is based on the patient's history and complaints. The sensitivity in the ischial spina region is typical. Most of the time there is pain in the coccyx. Pelvic tumor, which is miscible with Pudental syndrome, should be sure that there are no infections. 3 tesla MRI is used to diagnose neurograph, electromyography, pudendal block and pudendal nerve motor delay test for diagnosis.
 

How is the treatment done?

  • It is necessary to correct the conditions that trigger pain. It is necessary to avoid situations that increase pressure, such as cycling, horse riding or sitting for a long time. During urination and during defecation, it is necessary to avoid straining.
  • Pudendal block is used for both diagnosis and treatment.
  • Tricyclic antidepressants, anticonvulsants and nerve stabilizing drugs are oral drugs.
  • If pudendal nerve entrapment is detected, the liberalization of the nerve is surgical.

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