Editing Pudendal nerve (section)

===Imaging===
[[File:CT image guided injection pudendal nerve.png|thumb|Illustration of imaging from a CT-guided injection of the pudendal nerve at the pudendal canal.]]
The pudendal nerve is difficult to visualize on routine [[X-ray computed tomography|CT]] or [[MRI|MR imaging]], however under CT guidance, a needle may be placed adjacent to the pudendal [[neurovascular bundle]].  The [[ischial spine]], an easily identifiable structure on [[X-ray computed tomography|CT]], is used as the level of injection.  A spinal needle is advanced via the [[gluteal muscles]] and advanced within several millimeters of the ischial spine.  Contrast (X-ray dye) is then injected, highlighting the nerve in the canal and allowing for confirmation of correct needle placement.  The nerve may then be injected with [[cortisone]] and local anesthetic to confirm and also treat chronic pain of the external genitalia (known as [[vulvodynia]] in females), pelvic and anorectal pain.<ref>{{cite journal |author=Calvillo O, Skaribas IM, Rockett C. |title=Computed tomography-guided pudendal nerve block. A new diagnostic approach to long-term anoperineal pain: a report of two cases |journal=Reg Anesth Pain Med |volume= 25|issue=4 |pages=420–3 |year=2000 |pmid=10925942 |doi=10.1053/rapm.2000.7620|last2=Skaribas |last3=Rockett |s2cid=1622253 }}</ref><ref>{{cite journal |author=Hough DM, Wittenberg KH, Pawlina W, Maus TP, King BF, Vrtiska TJ, Farrell MA, Antolak SJ Jr. |title=Chronic perineal pain caused by pudendal nerve entrapment: anatomy and CT-guided perineural injection technique |journal=Am J Roentgenol |volume=181 |issue=2 |pages=561–7 |year=2003 |pmid=12876048 |doi=10.2214/ajr.181.2.1810561|last2=Wittenberg |last3=Pawlina |last4=Maus |last5=King |last6=Vrtiska |last7=Farrell |last8=Antolak Jr }}</ref>

====Nerve latency testing====
The time taken for a muscle supplied by the pudendal nerve to contract in response to an electrical stimulus applied to the sensory and motor fibers can be quantified. Increased conduction time (terminal motor latency) signifies damage to the nerve.<ref name=Santoro2010>{{cite book|last=G.A. Santoro, A.P. Wieczorek, C.I. Bartram (editors)|title=Pelvic floor disorders imaging and multidisciplinary approach to management|year=2010|publisher=Springer|location=Dordrecht|isbn=978-88-470-1542-5}}</ref>{{rp|46}} 2 stimulating electrodes and 2 measuring electrodes are mounted on the examiner's gloved finger ("St Mark's electrode").<ref name=Santoro2010 />{{rp|46}}