{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T18:00:35Z","timestamp":1772560835541,"version":"3.50.1"},"reference-count":9,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T00:00:00Z","timestamp":1772496000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T00:00:00Z","timestamp":1772496000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"JPSP KAKENHI","award":["JP 21I15335"],"award-info":[{"award-number":["JP 21I15335"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Colorectal Dis"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study aimed to examine the pudendal nerve in the context of tumors involving the pudendal canal and to clarify its anatomical course and the structural composition of Alcock\u2019s canal, while elucidating the relationships among the obturator internus nerve, sacrotuberous ligament, and fascia of the obturator internus muscle.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Six cadavers (12 pelvic halves) were dissected. The dissections focused on the pudendal canal, particularly the positions and interrelationships of the fasciae, muscles, ligaments, and surrounding fascial structures from medial and posterior perspectives.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The sacrotuberous ligament comprised two distinct layers, with the pudendal canal located within its structure. The proper fascia was distinguishable and situated on the muscle side of the obturator internus muscle. The pudendal nerve was traced within the fascia of the sacrotuberous ligament, whereas the obturator internus nerve coursed between the obturator internus muscle and its proper fascia. Coronal section examination of the right pelvis confirmed that the pudendal nerve was enveloped by fascia. The obturator internus nerve ran along the muscle side of the obturator internus fascia, occupying a layer distinct from that of the pudendal nerve.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The pudendal nerve travels within the fascia derived from the sacrotuberous ligament and does not pass through the fascia of the obturator internus. The proper fascia of the obturator internus muscle is located relatively close to the muscle, and the obturator internus nerve courses between the obturator internus muscle and its own fascia. These findings describe the anatomy of the pudendal canal and may provide a foundation for future surgical investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00384-026-05114-w","type":"journal-article","created":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T03:14:32Z","timestamp":1772507672000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Two layers of fascia envelop the pudendal nerve canal: a cadaver study"],"prefix":"10.1007","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8839-4483","authenticated-orcid":false,"given":"Kenro","family":"Chikazawa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoru","family":"Muro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoyuki","family":"Kuwata","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keiichi","family":"Akita","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,3,3]]},"reference":[{"key":"5114_CR1","doi-asserted-by":"publisher","first-page":"e951","DOI":"10.1097\/dcr.0000000000002764","volume":"66","author":"N Beppu","year":"2023","unstructured":"Beppu N, Song J, Takenaka Y, Kimura K, Kataoka K, Uchino M, Ikeuchi H, Ikeda M (2023) Transanal minimally invasive surgical approach to total pelvic exenteration. Dis Colon Rectum 66:e951\u2013e957. https:\/\/doi.org\/10.1097\/dcr.0000000000002764","journal-title":"Dis Colon Rectum"},{"key":"5114_CR2","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/j.ygyno.2020.12.034","volume":"161","author":"H Kanao","year":"2021","unstructured":"Kanao H, Aoki Y, Omi M, Nomura H, Tanigawa T, Okamoto S, Chang EJ, Kurita T, Netsu S, Matoda M, Omatsu K, Matsuo K (2021) Laparoscopic pelvic exenteration and laterally extended endopelvic resection for postradiation recurrent cervical carcinoma: technical feasibility and short-term oncologic outcome. Gynecol Oncol 161:34\u201338. https:\/\/doi.org\/10.1016\/j.ygyno.2020.12.034","journal-title":"Gynecol Oncol"},{"key":"5114_CR3","doi-asserted-by":"publisher","DOI":"10.3802\/jgo.2022.33.e34","volume":"33","author":"H Kanao","year":"2022","unstructured":"Kanao H, Nishimura M, Murakami A (2022) Laparoscopic resection surgery for malignant transformation of extragonadal endometriosis by the \u201cpincer\u201d approach. J Gynecol Oncol 33:e34. https:\/\/doi.org\/10.3802\/jgo.2022.33.e34","journal-title":"J Gynecol Oncol"},{"key":"5114_CR4","volume-title":"Gray\u2019s anatomy","author":"S Standring","year":"2021","unstructured":"Standring S (2021) Gray\u2019s anatomy, 42nd ed. Elsevier Health Sciences, the Netherlands","edition":"42nd ed"},{"key":"5114_CR5","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1002\/ar.1075","volume":"263","author":"HH Aung","year":"2001","unstructured":"Aung HH, Sakamoto H, Akita K, Sato T (2001) Anatomical study of the obturator internus, gemelli and quadratus femoris muscles with special reference to their innervation. Anat Rec 263:41\u201352. https:\/\/doi.org\/10.1002\/ar.1075","journal-title":"Anat Rec"},{"key":"5114_CR6","doi-asserted-by":"publisher","first-page":"614","DOI":"10.1007\/s00776-012-0243-7","volume":"17","author":"K Sato","year":"2012","unstructured":"Sato K, Nimura A, Yamaguchi K, Akita K (2012) Anatomical study of the proximal origin of hamstring muscles. J Orthop Sci 17:614\u2013618. https:\/\/doi.org\/10.1007\/s00776-012-0243-7","journal-title":"J Orthop Sci"},{"key":"5114_CR7","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1007\/s12565-023-00717-7","volume":"98","author":"S Muro","year":"2023","unstructured":"Muro S, Akita K (2023) Pelvic floor and perineal muscles: a dynamic coordination between skeletal and smooth muscles on pelvic floor stabilization. Anat Sci Int 98:407\u2013425. https:\/\/doi.org\/10.1007\/s12565-023-00717-7","journal-title":"Anat Sci Int"},{"key":"5114_CR8","doi-asserted-by":"publisher","first-page":"2313","DOI":"10.1007\/s00192-024-05851-y","volume":"35","author":"S Muro","year":"2024","unstructured":"Muro S, Chikazawa K, Delancey JOL, Akita K (2024) Skeletal muscle complex between the vagina and anal canal: implications for perineal laceration. Int Urogynecol J 35:2313\u20132322. https:\/\/doi.org\/10.1007\/s00192-024-05851-y","journal-title":"Int Urogynecol J"},{"key":"5114_CR9","doi-asserted-by":"publisher","first-page":"657","DOI":"10.1111\/joa.13810","volume":"242","author":"S Muro","year":"2023","unstructured":"Muro S, Nimura A, Ibara T, Chikazawa K, Nakazawa M, Akita K (2023) Anatomical basis for contribution of hip joint motion by the obturator internus to defaecation\/urinary functions by the levator ani via the obturator fascia. J Anat 242:657\u2013665. https:\/\/doi.org\/10.1111\/joa.13810","journal-title":"J Anat"}],"container-title":["International Journal of Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00384-026-05114-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00384-026-05114-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00384-026-05114-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T17:05:13Z","timestamp":1772557513000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00384-026-05114-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,3]]},"references-count":9,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["5114"],"URL":"https:\/\/doi.org\/10.1007\/s00384-026-05114-w","relation":{},"ISSN":["1432-1262"],"issn-type":[{"value":"1432-1262","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,3]]},"assertion":[{"value":"20 August 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 February 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 February 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 March 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Ethics Committee of the Tokyo Medical and Dental University (approval number M2018-006).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Prior to death, all donors voluntarily provided consent for their bodies to be used for educational and research purposes. Detailed explanations of the study methods were given, and informed consent was obtained from all donors. Following death, consent was reconfirmed with the donors\u2019 families to ensure that there were no objections.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Kenro Chikazawa received lecture honoraria from Ethicon (Tokyo, Japan), Terumo (Tokyo, Japan), and Chugai Pharmaceutical Co. (Tokyo, Japan). The remaining authors declare no conflicts of interest.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"75"}}