Pudendal Canal Decompression in the Treatment Of Erectile Dysfunction Due to Pudendal Canal Syndrome

Abstract

Erection in volves neurologic, hormonal, arterial, venous si nu soidaL and psychologi c factors. Erectile dysfunction (E D) can be caused by derangement of any one of the these factors. Ne urogenic di sorders a re caused by disease or dysfunction of the brain. s pinal cord, cavernous and pudendal nerves and tennina l nerve endin gs a nd receptors.

O ut of patients evaluated for E.D. the cause in 7 pati ents of ne urogenic E.D. was found to be pudendal nerve compress i on in pudendal canal. The pudendal nerve after leaving the pel vis, enters the pudenda l canal on the l ateral wall of the ischiorectal fossa. In the posteri or part of the canal , it gives off the inferior recta l nerve. ami the n di vides into the perinea l nerve a nd the dorsal nerYe of the pe nt s.

The clini cal picture and investigative results of the 7 patients were characteristic. The patients complained of E.D of long duration all had chronic constipation and straining at stool. There was impaired penile, perineal and scrotal sensation in all patien ts EMG showed reduced activity of the external urethral sphincter and l evator a ni muscle in all patients while of the external uret hra l sphincter was diminis hed in only 2 patients. The P.N. TML was increased on both sides.