Pour aller plus loin sur la névralgie pudendale

Anatomie du nerf pudendal

Le nerf pudendal est un nerf mixte : sensitif des organes génitaux, moteur pour les muscles du périnée, et aussi végétatif.

Le nerf pudendal est une des branches du plexus lombo-sacré, issu des racines nerveuses sacrées de S2 à S4. Accompagné de l’artère et veine pudendales internes, il circule le long du bord antérieur du muscle piriforme avant de pénétrer dans la région fessière. Il se prolonge ensuite dans la pince ligamentaire formée par les ligaments sacro-isciatique et sacro-tubéral sous l’épine ischiatique.

Enfin, il se poursuit dans le canal d’Alcock, qui correspond à un dédoublement de l’aponévrose du muscle obturateur interne, le ligament falciforme.

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Au cours de ce trajet, trois branches principales émergent : 

  • Le nerf rectal, qui contribue à la sensibilité de la marge anale et à la motricité du sphincter externe strié de l’anus et rectum.
  • Le nerf périnéal, qui assure l’innervation sensitive du périnée, des bourses et de la verge chez l’homme, des grandes lèvres chez la femme, et motrice des muscles ischio et bulbo-caverneux et le sphincter strié de l’urètre.
  • Le nerf dorsal de la verge ou du clitoris, participant à l’érection.
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