LKnative – Pudendal nerve block

Indications for the transperineal ultrasound guided pudendal nerve block

The transperineal ultrasound guided pudendal nerve block is indicated for postoperative analgesia after pelvic floor surgery including rectal extirpation.

The described technique is invented by Dr. Teresa Parras from St. Georges Hospital, London, UK, who has contributed the sonoanatomy pictures of the module.

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Perineal area: The anterior and posterior triangles

The perineal area can be divided into two triangles: the anterior (synonym: urogenital) triangle and the posterior (synonym: anal) triangle. The base of both triangles is the superficial transverse muscles. The lateral borders of the anterior triangle are the ischiocavernosus muscles. The lateral borders of the posterior triangle is the sacrotuberous ligament.
The anterior triangle contains the root of the scrotum and penis in males and the vulva in females and it extends from the transverse perineal muscle to the pubic symphysis.
The posterior triangle contains the anal canal and its external orifice – the anus – and it extends from the transverse perineal muscle to the coccygeal bone.