Surgical anatomy of sciatic nerve and pudendal Nerve in deep gluteal space and its clinical Relevance

Damage to nerves arising from sacral plexus including sciatic nerve (SN) and pudendal nerve (PN) can greatly compromise bowel, bladder, and sexual functions and may also result in severe motor dysfunction in the lower extremities.1 Incontinence happens when the external anal and vaginal sphincters lose their nerve supply because of damage to the sacral nerve.2 The complexity of sacral plexus injuries poses significant challenges to functional reconstruction by limiting available surgical options. As a result, there is scarcity of data suggesting treatment strategies that are currently applicable in clinical practice, often leading to suboptimal and incomplete functional recovery. Some surgical methods including direct anastomosis and nerve transfer have been established recently and show some purposeful recoveries in case of bladder and bowel incontinence.