Magnetic resonance imaging anatomy of pudendal nerves in mature men after surgical interventions on pelvic organs

Abstract

 The work studied the magnetic resonance imaging (MRI) anatomy of the pudendal nerves in mature men who underwent surgery on pelvic organs. The study included 75 patients (30 patients in the first period of adulthood and 45 patients in the second period of adulthood). Thirty-seven patients underwent prostatectomy and 38 respondents underwent rectal resection. The single-trunk nature of the branching of the nerve, in which the pudendal nerve passes under the sacrospinous ligament, was found in the majority of patients (65.3%). The sources of formation of the pudendal nerves in 45 (60.0%) cases were the roots S2, S3 and S4, in 19 (25.3%) respondents the pudendal nerves were formed from the roots S2 and S4 and in 11 (14.6%) of respondents, the nerves originated from the S3 and S4 roots. The genital canals originate 22.5±3.2 mm below the ischial tuberosity and lie 39.8±9.5 mm anterior to it, the canals end at the level of the lower edge of the pubic symphysis 24.4±10.9 mm behind it. The average cross-sectional area of the genitals was 27.9±9.2 mm2. The average diameters of the pudendal nerve trunks at a level of 2 cm distal to the piriformis muscle were 4.63 mm, 1.85 mm, and 1.64 mm for the first, second, and third trunks, respectively. The average length of the pudendal nerve trunks before division into terminal branches was 25.23 mm. A comparison of the skeletotopic characteristics of the genital canals between patients with a conditional norm and patients after surgery on the pelvic organs demonstrated the presence of significant differences (p=0.023).