Ann Rehabil Med.  2016 Aug;40(4):741-744. 10.5535/arm.2016.40.4.741.

Pudendal Nerve Entrapment Syndrome due to a Ganglion Cyst: A Case Report

• Lee JW
• Lee SM
• Lee DG

• KMID: 2356661
• DOI: http://doi.org/10.5535/arm.2016.40.4.741

Abstract

Pudendal nerve entrapment syndrome is an unusual cause of chronic pelvic pain. We experienced a case of pudendal neuralgia associated with a ganglion cyst. A 60-year-old male patient with a tingling sensation and burning pain in the right buttock and perineal area visited our outpatient rehabilitation center. Pelvis magnetic resonance imaging showed the presence of multiple ganglion cysts around the right ischial spine and sacrospinous ligament, and the pudendal nerve and vessel bundle were located between the ischial spine and ganglion cyst at the entrance of Alcock's canal. We aspirated the lesions under ultrasound guidance, and consequently his symptoms subsided during a 6-month follow-up. This is the first report of pudendal neuralgia caused by compression from a ganglion cyst around the sacrospinous ligament.

Keyword

Pudendal nerve entrapment syndrome; Pudendal neuralgia; Ganglion cysts; Ultrasonography

MeSH Terms

Burns
Buttocks
Follow-Up Studies
Ganglion Cysts*
Humans
Ligaments
Magnetic Resonance Imaging
Male
Middle Aged
Outpatients
Pelvic Pain
Pelvis
Pudendal Nerve*
Pudendal Neuralgia*
Rehabilitation Centers
Sensation
Spine
Ultrasonography

Figure

• 

  Fig. 1 Axial T2-weighted image showed multiple cystic lesions (arrowheads) through the right ischial spine and sacrospinous ligament (A). Pudendal nerve and vessel bundle (arrow) are located between the ischial spine (IS) and the ganglion cyst at the entrance of Alcock's canal (B) and in Alock's canal passing the ganglion cyst (C). GMax, gluteus maximus.

• 

  Fig. 2 (A) Ultrasound image obtained using a linear probe showed a bilobed cystic mass (asterisks) in the gluteal area around the ischial bone (white arrow). (B) Long-axis ultrasound image using a round probe guides a 16-gauge spinal needle (arrow head) to the ganglion cystic mass for aspiration. (C) About 4 mL of thick mucoid material was aspirated.

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