The perineal branches of the posterior femoral cutaneous nerve arise from its medial side at the level of the ischial tuberosity, curving medially around the thigh to supply the lateral scrotum or labium majus. They provide the most inferior scrotal or labial cutaneous innervation.
The perineal branches of the posterior femoral cutaneous nerve are injured in ischiogluteal bursitis, hamstring origin repair, and posterior thigh approaches. They may be compressed by a tight bicycle saddle in cyclists, contributing to perineal numbness. Perineal branch injury during hamstring origin repair can produce dysaesthesiae in the scrotum or labia that are distressing to the patient.
Scrotal or labial numbness and burning from perineal branch injury during posterior thigh surgery or sustained saddle pressure in cyclists, usually self-limiting but occasionally requiring neuroma management.
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