Sacrospinous colpopexy: management of postoperative pudendal nerve entrapment

Abstract

Background: Sacrospinous colpopexy requires the placement of a suture through the sacrospinous ligament, under which lies the pudendal nerve. Entrapment of this nerve may result in perineal or buttock pain. This report analyzes a case of pudendal nerve entrapment and studies the management of the resultant neuropathy.

Case: A 62-year-old patient experienced a chronic pudendal neuropathy with perineal and buttock pain following a sacrospinous colpopexy. Removal of the suture, 2 years after it was originally placed, resulted in immediate relief of her pain. She has been asymptomatic for 1 year following surgery.

Conclusion: Pudendal nerve entrapment should be considered in the differential diagnosis of perineal or buttock pain after sacrospinous colpopexy. Relief of pain can be achieved even 2 years after initial surgery.