After falling down while engaged in sports several years ago, a 36-year-old Finnish teacher traveled to Memorial Hospital in Istanbul for treatment by one of the most well-respected and renowned orthopedic surgeons in the country.

The patient was diagnosed with a compression of the pudendal nerve, one of the largest bundles of nerves that exit the spine and travel toward the pelvic region. These nerves are responsible for response and reaction of pelvic organs including female and male genitalia. The Finnish patient was in extreme pain, although the definitive cause of pain remained undiagnosed for a long time in her home country of Finland. Recommended treatments just didn't work, and the patient soon experienced bouts of depression.


 

Pudendal nerve compression or pudendal nerve entrapment is often caused by a difficult labor in childbirth process, as well as the sport of bicycling, which causes a stretching or compression of the pudendal nerve. Compression against the nerve causes temporary lapses of function, caused by the literal entrapment of the pudendal nerve between ligaments found in the pelvic region, often affecting urination, sexual activity, and evacuation.

The Finnish patient, diagnosed with pudendal nerve compression and/or entrapment, reached out to Professor Dr. Tibet Erdoğru, a renowned urologist professor/surgeon in Istanbul. Dr. Erdoğru is a member of the surgical staff at Memorial Hospital, part of the Memorial Health Group, the first JCI accredited hospital group in Turkey. Doctors and surgeons at Memorial Hospital group are dedicated to offering quality, state-of-the-art, first-class medical services that adhere to ethical and international standards of care.

The Finnish patient traveled to Istanbul after recommended treatments did not work, finding Dr. Erdoğru through a variety of websites created by individuals who had similar problems. The patient arrived in Istanbul, accompanied by a Finnish orthopedic surgeon who wanted to observe the surgical procedure. Dr. Erdoğru and Dr. Egemen Avci performed laparoscopic surgery, expanding the patient's spinal channel, thereby relieving compression and pressure caused by the pudendal nerve against the spine.

The pudendal nerve decompression surgery is recommended for individuals for whom more conservative therapies fail to provide relief. Such therapies may include but are not limited to pelvic floor exercises and physical therapy, nerve blocks, and lifestyle changes.  Success rate for pudendal nerve decompression surgery ranges between 60% and 85%, and in the reduction of nearly 50% of pain in most patients.

Nerves are often entrapped by contracted muscles, tight ligaments, or misaligned public structure, which causes nerve endings to rub or press against one or more of the ligaments that surround it. The most common surgical approaches for the pudendal nerve decompression surgery include a laparoscopic-robotic approach, which allows better magnification and high definition visualization of the nerve during the surgical procedure. Dr. Erdoğru has performed over 400 laparoscopic pudendal nerve decompression and transposition surgical procedures. The approach causes less bleeding and post-op pain, a shorter post surgery hospitalization, and a more rapid return to daily lifestyle and activities.

Dr. Erdoğru is a specialist in laparoscopic and robotic surgical procedures, with over 1,000 laparoscopic and da Vinci robotic surgery system technology in urology under his belt. The laparoscopic surgical procedure offers a less invasive option for patients dealing with nerve entrapment. Dr. Erdoğru heads the Department of Urology and the Advanced Laparoscopic and Robotic Surgery Center in urology at Memorial Hospital,Istanbul.