Electrophysiological analysis of pudendal neuropathy following traction

Pudendal neuropathy is an unusual but important complication of orthopedic surgical procedures involving traction on the fracture table. We describe t he clinical and electrophysiological features in six patients presenting wi th perineal sensory disorders and sexual dysfunction following surgical rep air of femoral fracture, hip dislocation, or intra-articular foreign body, in which the traction table was used. All underwent electrophysiological re cordings: bulbocavernosus muscle electromyography (EMG), measurements of th e bulbocavernosus reflex latencies (BCRLs), somatosensory evoked potentials of the pudendal nerve (SEPPNs), sensory conduction velocity of the dorsal nerve of the penis (SCVDNP), and pudendal nerve terminal motor latencies (P NTMLs). Signs of denervation localized to the territory of the pudendal ner ve were found in 3 patients, normal BCRL in 6, abnormal SEPPNs in 4, and ab normal SCVDNPs and PNTMLs in all cases. The outcome at ii-year follow-up wa s good, except in one patient with initially unrecordable PNTML. Perineal e lectrophysiological examination can thus confirm the pudendal neuropathy an d give prognostic information. (C) 2001 John Wiley & Sons, Inc.