Health Organization for Pudendal Education

There us anterior angulation of the coccyx, which is minimally deviated to the right. The anococcygeal ligament appear symmetric as is the coccygeous muscle. The sacrospinous and sacrotuberous ligaments appear symmetric and there is no scar entrapment of the pudendal nerves adjacent to the ligaments. Hamstring tendinosis is seen without ischial bursitis. The pudendal nerves in the posterior margin of Alcock’s canal appear unremarkable. There is scar on the left surrounding the superficial perineal muscles at the vestibule, extending to the lateral side wall of the Alcock’s canal and abutting some of the anterior inferior perineal branches of the pudendal nerves that extend to the anterior margin of the anus. This is noted on series 6, images 17 through 21. This is also present but to a much lesser extent on the right. The posterior inferior perineal branches appear unremarkable. The levator ani muscles appear symmetric. The obturator internus muscles also appear unremarkable. There is some resorption of the inferior margin of the pubic symphysis, with a projection of bone off the posterior margin of the right pubis, seen on series 6 images 38 and 39, abutting small branch vessels but not directly abutting the dorsal nerve to the clitoris. Dorsal nerves to the clitoris appear fairly symmetric. No pelvic adenopathy is seen. There is some prominence of the pericervical venous plexus but without features to suggest marked pelvic venous congestion syndrome. Varices do extend into the anteroinferior margin of Alcock’s canal, more prominent on the right than the left.

There is no occult fracture or osteonecrosis. There is thickening of the greater trochanteric bursae but no bulky bursitis. Images obtained anteriorly demonstrate no appreciable scarring around the genital branches of the genitofemoral or the ilioinguinal nerves.

No regional adenopathy is seen. Small foci of diminished signal intensity are seen in the uterus compatible with small degenerative leiomyomata.

Impression
MRI of the pelvis demonstrates scarring of the pelvic floor localized around the superficial perineal muscles, extending to the left lateral margin of Alcock's canal adjacent to the pudendal nerve, as well as around the anterior inferior perineal branches to the anus. There are slightly prominent veins in the Alcock's canal inferiorly without evidence of extensive pelvic venous congestion syndrome. The nerves more posteriorly adjacent to the sacrotuberous ligaments appear unremarkable.

Dear PNSucks,

Welcome to HOPE. Your MRI report indicates that Potter doesn't think you have pudendal neuralgia. Who diagnosed you with PN? Have you had physiotherapy with a pelvic pain specialist? Maybe the source of your pain is muscular, a.k.a. pelvic floor myalgia? Do not despair; not having PN is a good thing!! It means that you may obtain relief with less invasive methods than surgery. Please continue to peruse this website for more information and ideas on how to tackle your pelvic pain. You will find something that works for you.

I don't know, I'm not a doctor but maybe it would be a good idea to seek further clarification from Dr. Potter. I have a friend who had similar language about "scarring" in her Potter MRI report and when she asked Dr. Potter for clarification was told that "yes" she was entrapped.

I would say your nerve is entrapped in scar tissue at Alcock's and the perineal branch.

c