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Pudendal Neuropathy Involving the Perforating Cutaneous Nerve After Cystocele Repair With Graft

Bohrer, Justin C. BS1; Chen, Chi Chiung Grace MD2; Walters, Mark D. MD2

doi: 10.1097/AOG.0b013e31817f19b8
Case Reports
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BACKGROUND: Pudendal neuropathy is a documented complication of sacrospinous ligament fixation, but it is infrequently reported with other types of gynecologic surgery.

CASE: A woman developed neuropathic symptoms of the right vulva, perianal area, and gluteal fold after vaginal surgery with graft for anterior pelvic organ prolapse. Pudendal nerve entrapment with involvement of the perforating cutaneous nerve was suspected. Suture removal 1 year after the operation resulted in improved pain symptoms and sexual function.

CONCLUSION: Pudendal nerve entrapment is one potential complication of anterior vaginal repair with biologic graft. Removal of sutures, even long after surgery, can result in clinically significant improvement in pain symptoms and sexual function in patients with pudendal nerve entrapment.

Pudendal nerve entrapment is one potential complication of anterior vaginal repair with biologic graft.

From the 1Cleveland Clinic Lerner College of Medicine of Case Western Reserve University; and the 2Institute of Obstetrics, Gynecology, and Women’s Health, Cleveland Clinic, Cleveland, Ohio.

Corresponding author: Mark D. Walters, MD, Cleveland Clinic, Department of Obstetrics and Gynecology, 9500 Euclid Ave, A81, Cleveland, OH 44195; e-mail: walterm@ccf.org.

Financial Disclosure Dr. Walters is a consultant and lecturer for American Medical Systems (Minnetonka, MN) and a consultant for Boston Scientific (Natick, MA). The other authors have no potential conflicts of interest to disclose.

© 2008 The American College of Obstetricians and Gynecologists