A potential bursal space associated with the sacrospinous ligament where it passes adjacent to the ischial spine, between the ligament and the coccygeus muscle. It may become inflamed from pelvic floor dysfunction, pudendal nerve entrapment surgery, or sacrospinous colpopexy fixation.
Sacrospinous ligament bursitis occurs as a complication of sacrospinous colpopexy, where sutures through the ligament cause local bursitis and pudendal nerve irritation. The pudendal nerve and internal pudendal vessels pass medial to the ischial spine adjacent to this bursa. Post-colpopexy buttock pain responsive to pudendal nerve block suggests involvement of this bursal region. Suture granuloma in this area mimics sacrospinous bursitis on MRI.
Bursal inflammation and pudendal nerve irritation at the sacrospinous ligament from colpopexy suture fixation, producing unilateral buttock pain and perineal discomfort managed with pudendal nerve block and suture removal if refractory.
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