Dear Dom,desperate wrote:Hello doctor,
I know this is a little off the topic of nerve blocks but I am just wondering if you can differentiate between pudendal vs the superior hypogastric nerve?
From your years of experience has anyone come into your clinic with absolutely no urge to urinate at all? The reason I ask is because I do not know if no urge to urinate is a symptom of PNE or another nerve like the hypogastric nerve. I know these are the only two nerves that innervate the bladder so I'm curious to hear your thoughts.
Thank you so much
-Dom
This is a good question.
I'll refer you to the EXCELLENT anatomy education at:
http://www.pudendalhope.info/node/13
The pudendal nerve is a sensory and partial motor nerve. The pudendal nerve transmits (or causes) pain along a very discreet anatomical area.
The hypogastric nerve is a transition zone between the superior and inferior hypogastric plexus. It is not a target for interventional pain procedures in general. We always prefer to target the superior or inferior hypogastric plexus.
http://en.wikipedia.org/wiki/Hypogastric_nerve
The superior hypogastric plexus is a spider-web like cluster of nerves that lives just ventral to the L5-S1 disc and sacrum.
http://en.wikipedia.org/wiki/Superior_h ... ric_plexus
It is not a "nerve" per se, but a cluster of them. It also is a sympathetic plexus. The sympathetic nerve system is a distinct part of your anatomy and it is responsible for some pain sensations, blood flow, hair growth, hormone release,etc. We can do injections to the superior hypogastric plexus to alleviate generalized pelvic pain, typically originating from the organs. We can also kill the hypogastric plexus with alcohol or phenol injections for people with invasive tumors in the area.
I cannot say I've had any patients without the urge to unrinate unless they have suffered from a spinal cord injury or stroke. This symptom is usually not a result of or associated with typical pelvic pain issues.
Best Regards, Dr. Attaman