Talk:Pudendal nerve entrapment

Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 7 June 2021 and 27 August 2021. Further details are available on the course page. Student editor(s): R. Salonga UCSF, R. Mohsin, Future UCSF Pharm.D., Rfortney, RLUUCSF. Peer reviewers: Chriscui0823.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 07:29, 17 January 2022 (UTC)

comment

• Aforementioned ligaments? No ligaments were mentioned. This should be cleared up. *Fixed*
• Reference needed at the point where is stated that "Acupuncture has helped decrease painlevels for some people".
• I have corrected the acupuncture statement - I have never heard of anyone getting relief with this. PI Admin.
• The information provided in this page is misleading and inaccurate. As a professional in the health care field and individual suffering with PNE I recommend that the editor amend or correct the information provided in this page.
• I also feel that this page is misleading, I am suffering from PNE for over three years, but the Doctor I fianlly found in the USA has done over 100 decompresion surgeries in 3 years. Hoever is quoting zero is not talking to the 2-3 Doctors in the US that perform decompression surgeries. Also, PNE can occur simply from sitting motionless for extended periods of time. —Preceding unsigned comment added by 75.68.62.36 (talk) 21:18, 21 August 2010 (UTC)

Allot info to find about it at: [1] Link to community forum for sufferers KRISG22 KRISG22 (talk) 14:08, 4 September 2010 (UTC)

• I agree that the page is misleading and does not reflect the progress in this field — Preceding unsigned comment added by Manon13 (talk • contribs) 11:43, 12 December 2010 (UTC)

I am not an expert, but my mother suffered very badly from this, and I think I may be developing it too. One of her major symptoms was the sensation of having something painful inserted vaginally or anally. We only realised what she had when we read this specific symptom, unfortunately after she had gone undiagnosed for many years- and after her death. She could not sit down comfortably and spent most waking hours standing, avoiding excursions or meals with friends because of the discomfort of sitting, not to mention severe pain near the end of her life. To me this, above all other symptoms, characterised her problem. I think this article places undue emphasis on male bikers because my research has indicated that women are more frequently affected than men - and neither my mother nor myself are competitive or long distance bike riders Coleennam (talk) 11:29, 19 July 2012 (UTC)

Edit request on 6 April 2012

I would like to request two changes to this page. They are as follows.

First, in the causes section, here is an excerpt of the current language.

PNE can be caused by pregnancy, scarring due to surgery, accidents and surgical mishaps. Anatomic abnormalities can result in PNE due to the pudendal nerve being fused to different parts of the anatomy, or trapped between the sacrotuberous and sacrospinalis ligaments. Heavy and prolonged bicycling, especially if an inappropriately shaped or incorrectly positioned bicycle seat is used, may eventually thicken the sacrotuberous and/or sacrospinous ligaments and trap the nerve between them, resulting in PNE.

I request that you add the following as a new last sentence to the foregoing paragraph.

Repeated mechanical irritation to the pudendal nerve caused by prolonged cycling can result in the accumulation of scar tissue and thereby trap the nerve along its perineal branch and, in men, along the dorsal nerve to the penis.

Second, in the surgery section, there is a paragraph that reads as follows:

Three types of surgery have been done to decompress the pudendal nerve: transperineal, transgluteal, and transichiorectal. A follow-up of patients of this surgery after 4 years found that 50% felt their pain had improved to various extents, although control patients were not followed up for comparison.

I request that you add the following sentence immediately after the preceding paragraph:

However, the studies and surgical methods cited above generally focused on the Alcock’s canal and the area between the sacrotuberous and sacrospinous ligaments as likely sites for entrapment. More recent studies have identified possible entrapment sites anterior to Alcock’s canal. After this sentence, please add a reference to the following study: Hruby, S.; Ebmer, J.; Dellon, A.; Aszmann, O. (2005). “Anatomy of Pudendal Nerve at Urogenital Diaphragm—New Critical Site for Nerve Entrapment.” Urology 66 (5): 949-952. doi:10.1016/j.urology.2005.05.032. Jctkelly (talk) 05:17, 6 April 2012 (UTC)

 Partly done first part -- not done due to lack of source. Second part -- done. Pol430 talk to me 22:02, 8 April 2012 (UTC)

Investigations

Pudendal nerve terminal motor latency

Staged sacral reflexes: The sacral reflexes are made at the ventral and dorsal quadrants of the anal sphincter and at the pubococcygeus muscle. Considering the values of the differential staged sacral reflexes obtained between ventral and dorsal quadrant of the anal sphincter between dorsal quadrant of the anal sphincter and pubococcygeus muscle, an entrapment of the pudendal nerve can be evoked with a topographic orientation (infrapiriformis area and/or ischiorectal fossa). Ref: Differential staged sacral reflexes allow a localization of pudendal neuralgia http://www.pelviperineology.org/march_2009/pdf/differential_staged_sacral_reflexes_allow_localization_pudendal_neuralgia.pdf — Preceding unsigned comment added by Panveer (talk • contribs) 12:55, 13 May 2012 (UTC)

References

New edits

The paragraph The main symptom is neuropathic pain .... either the right or left side. is cited to PMID 17828787, but this information is not in the abstract. If the sentences are not cited, it's original research and must be taken out. MLPainless (talk) 01:34, 24 April 2013 (UTC)

Perhaps we should AFG that the sourced material is in the rest of the article even if it is not in the abstract. Lesion (talk) 22:58, 17 January 2014 (UTC)

Scope of this article?

This article seems a bit poorly focused, and seems to discuss any pathology of the pudendal nerve. I therefore propose that the article be renamed pudendal neuropathy and redrafted as appropriate, where each cause (e.g. entrapment) is given its own section. Thoughts? Lesion (talk) 22:58, 17 January 2014 (UTC)

Physical therapy section - edit request

Apparently, "One more possibly helpful stretch for bicyclists include sitting in the lotus position and moving your head to the ground supporting yourself with your hands and keeping your buttocks up." Really?. I think this should be removed, per WP:ADVICE. 86.134.200.29 (talk) 08:50, 21 August 2014 (UTC)

I've removed the sentence, as well as a few of the others around it—Wikipedia is not a how-to guide, and the information was uncited as well. —Mr. Granger (talk · contribs) 15:16, 22 August 2014 (UTC)

Semi-protected edit request on 21 January 2020

Citation needed regarding chiropractic manipulations being an effective treatment. Jedwardsdpt (talk) 20:21, 21 January 2020 (UTC)

Removed – Thjarkur (talk) 00:19, 22 January 2020 (UTC)

Foundations 2, 2021 Group 25 Goals

Our goals for this article include:

• Add an anatomy section
• Cite sources for sections missing references(Physical therapy and ergonomics)
• Update citations with newer publications
• Expand on majority of sections

Future editors may improve this article as more sources become available. Rfortney (talk) 21:56, 26 July 2021 (UTC)

Peer Review from Group 7

Mandatory Questions:
1. Do the group's edits substantially improve the article as described in the Wikipedia peer review "Guiding framework"?

• The group's edits do improve the article as they have expanded on the main topics of discussion: signs and symptoms, diagnosis, treatment, etc. I feel that each section was described in a way that allows readers to understand what PNE is, even though it is not super well understood at a baseline. C.Hancock, Future UCSF PharmD (talk) 21:31, 2 August 2021 (UTC)

• In alignment with the "Guiding framework" criteria, the group significantly adds substantial edits to the article. The extent of detail specifically in the various forms of treatment and making each their own separate subheader allowed great detail to be cited. The group was also able to successfully define the PNE condition that made the overall article easy to follow, especially with constant reminders of what the condition was and where in the body it affected the person. C.Santamaria, UCSF PharmD candidate (talk) 21:46, 2 August 2021 (UTC)

• The group have done a great work on expanding the article. The overall structure is clear and the content is consistent throughout. However, the content sometimes might be not well-structured. Information are simply spreaded all over without a main line. It might be better to put them in order and make the logic more smooth. Chriscui0823 (talk) 21:17, 3 August 2021 (UTC)

2. Has the group achieved its overall goals for improvement?

• The group has definitely improved the overall article and has hit the major topics. I think there is some room for improvement such as: including where the reviews are from, instead of saying "a review", also there were a few typos and grammatical errors that can be easily fixed. C.Hancock, Future UCSF PharmD (talk) 21:49, 2 August 2021 (UTC)

• Overall, the group has achieved the goals for improvement of the article. The article is very extensive in the amount of detail it provides and it utilizes an ample amount of sources embedded throughout the article. Very few typos are present in the article but it is so minimal that the overall message of the article is received. C.Santamaria, UCSF PharmD candidate (talk) 21:52, 2 August 2021 (UTC)

• The goals of the group were to update old citations, add new references, expand the article overall, and add a new section of anatomy. The group clearly achieved their goals. Now they got 42 references and they are very up to date. The article is full of flesh and explain the topic full enough to get the big picture. Anatomy section explains well of the mechanism of the medical condition. Chriscui0823 (talk) 21:17, 3 August 2021 (UTC)

3. Does the draft submission reflect a neutral point of view?

• The group did a good job at indicating they were using information from a number of reviews, they even mentioned how one of the "gold standards" according to one person has received some criticism and may not actually be the gold standard that they believed. C.Hancock, Future UCSF PharmD (talk) 21:34, 2 August 2021 (UTC)

4. Are the edits formatted consistent with Wikipedia's manual of style?

• According to the manual of style, for entries of diseases, disorders, or symptoms, suggested listing of content includes epidemiology, signs and symptoms (subsection complication), etiology, mechanism, diagnosis (subsection classification), prevention, treatment, prognosis, etc. The content group 24 has in the article can roughly match the recommendation, especially the treatment section very well developed. Since PNE is predominantly a surgical condition, I think it is fine to equal the anatomy section with mechanism. The introduction section summarize the content listing roughly, but the structure can be more refined to really lead the rest of the article and some specific, detailed information should be moved down into the body. Overall, the content is consistent with the topic. Chriscui0823 (talk) 21:47, 2 August 2021 (UTC)

5. Do the edits reflect language that supports diversity, equity, and inclusion? The article remains very neutral in regards to treatment, in particular, by portraying various treatment options but including the cons as well as the pros for each type. The article uses citations that directly discuss why practitioners prefer one treatment over the other. Regarding inclusion, the article highlights the etiology of PNE on both males and females, and for other etiologies the writers keep the terms gender neutral and describes how PNE can be caused in a more general manner. C.Santamaria, UCSF PharmD candidate (talk) 22:04, 2 August 2021 (UTC)

References

Recent edits

I have noticed a tag team of editors, or is it one editor with multiple accounts? (this is not allowed BTW), suddenly working intensely on this article. I have stopped the use of a case history as source for a lot of edits. Please carefully read WP:MEDRS and note that review studies are the preferred source for medical articles.

Another issue is the use of the phrase " is used by many physicians" in relation the so-called 'Nantes criteria'. That phrase is not in the source, and is therefore WP:OR. The actual phrase is "this criterion has validation by many European physicians", which is quite different.

And since some sources (especially Antolak) completely refute the Nantes Criteria, they should be referred to in the article more briefly, not listed in such detail. Ratel 🌼 (talk) 23:26, 30 July 2021 (UTC)

Thank you for your review of the page and recent edits. We are a group of students that are assigned to this article as a school assignment. We are aware of the studies preferred by wikipedia and have only recently added secondary references such as systematic reviews. The phrase was also fixed a bit after it was published. RLUUCSF (talk) 16:37, 3 August 2021 (UTC)

2 edit requests

1. 'Perineal branch' is now linked to 'Perineal branches of posterior femoral cutaneous nerve', but it's wrong link. How can pudendal nerve branches off 'perineal branches of posterior femoral cutaneous nerve? As pudendal nerve branches off perineal nerve, 'perineal branch' should be linked to 'perineal nerve'. (Pudendal nerve entrapment#Anatomy)

2. What is 'digital palpitation'? I think it should be 'digital palpation', since the Tinel sign is also performed by percussion. (Pudendal nerve entrapment#Diagnosis)

If I am wrong, please refuse these requests. Thank you. --LR0725 (talk) 14:52, 26 February 2022 (UTC)

 Not done: According to the page's protection level you should be able to edit the page yourself. If you seem to be unable to, please reopen the request with further details. ScottishFinnishRadish (talk) 14:59, 26 February 2022 (UTC)

I saw red alert message, so I thought I cannot edit myself. Thank you. --LR0725 (talk) 15:08, 26 February 2022 (UTC)

This article has neutrality issues

I've noticed a number of edits to this article which appear to start with a premise and attempt to find sources supporting those viewpoints. The premise is typically doubts about the existence of PNE as a cause of pudendal neuralgia and the validity of pudendal nerve decompression surgery. There are several issues here:

1. Exaggeration of claims with this premise (e.g. reference finds that pudendal nerve passes through sacrospinous ligament, suggesting that PNE attributed to that entrapment point is overestimated. The wiki content says that this puts into question the thesis of pudendal nerve entrapment altogether, which is an exaggeration)
2. Incorrect references for claims with this premise (e.g. content says fall 2003 EAU guidelines makes a claim, the actual citation of 2004 EAU guidelines, which are only published once every few years, says nothing of that matter. I am not actually sure if the quote is real or made up.)
3. Biased language. (e.g. "According to the supporters of the theory of PNE...")

Since this article has protection I am assuming these neutrality issues with editors are not new. I have changed the wording for (1) and added "citation needed" templates for (2).

I think it's valuable to include historical disputes about the existence of PNE and the validity of pudendal nerve decompressions and think this is more appropriate for a "controversy" subsection of a "history" or "society and culture" section, as I have written for nerve decompression and nerve compression syndrome. What I disagree with is bringing up the controversy in a way that distracts from the article's substance, such as "according to the guys who actually believe this...", giving undue weight to critics in sections where it's not relevant (e.g. giant paragraph about unverifiable EAU quote when they could just _list_ the actual surgical outcomes and let the reader decide), or inserting random critiques (e.g. a study of 14 cadavers in the lead section).

This has been a long explanation, but essentially the neutrality of one or more editors in this article is questionable and the discussion of the controversy is better put in its own section rather than polluting the article. Snake playing a saxaphone (talk) 06:03, 10 August 2024 (UTC)