Ten-Step Surgical Approach to Management of Pathology of the Ischiorectal Fossa-A Review of the Literature and Application in a Rare Pelvic Schwannoma

J Invest Surg. 2022 May;35(5):1067-1073. doi: 10.1080/08941939.2021.2002481. Epub 2021 Dec 5.

Abstract

Objective: The ischiorectal fossa is a key anatomical location with boundaries and internal structures owing distinct contributions to function and quality of life. Methods: We highlight the importance of management of pathology in this deep anatomically complex location. Results: We present a ten-step multidisciplinary surgical approach; achieving en bloc radical excision with primary closure and reassuring outcomes. Schwannomas are benign slow-growing nerve sheath tumors. Conclusions: Pelvic schwannomas are rare with only 3 reported cases of the pudendal nerve. We also offer an overview of this rare pathology whilst acknowledging a paucity of recommendations regarding management of disease of the ischiorectal fossa.

Keywords: Pudendal schwannoma; anatomy; en-bloc; primary closure; radical excision.

Publication types

  • Review

MeSH terms

  • Humans
  • Neurilemmoma* / diagnostic imaging
  • Neurilemmoma* / pathology
  • Neurilemmoma* / surgery
  • Quality of Life*
  • Rectum / pathology