Introduction: Peripheral neurophathy has been attributed for more than 80% of diabetic impotence. Decompression of peripheral nerves at other anatomic sites has lead to longlasting improvement of nerve function. For the pudendal nerve such a compression site has also been described, however indication for surgical decompression, and outcome measures have never been presented. In the following work we describe the detailed anatomy of the pudendal nerve at its passage through the urogenital diaphragm into the base of the penis. Normative neurosensory data of the penis of normal subjects, diabetics and pre and postoperative results are presented. Materials & Methods: Detailed anatomic dissections were carried out in five formalin preserved cadavers under 3.5X loupe magnification. The pudendal nerve was dissected from the entrance into Alcocks canal to the dorsum of the penis. The branching pattern of the nerve and its topographical relationship were recorded and photographs taken. Normative neurosensory data of the penis (glans/shaft/perineum) of 20 normal individuals and 10 diabetics were obtained. Finally, pre-and postop data of 5 patients with a follow up of 18 months are presented. Results: The anatomic dissections revealed that the pudendal nerve passes through a tight osteofibrotic canal just distal to the urogenital diaphragm at the entrance to the base of the penis. This canal is in part formed by the inferior ramus of the pubic bone, the ligamentum fundiforme penis and the ischiocavernous body. Neurosensory evaluation revealed that classic two-point discrimination was not a valid parameter in penile sensation. However, one point pressure threshold testing was significantly higher in diabetics (25±14 gm/mm˛) than in normal subjects (1.1±0.6 gm/mm˛) for all three testing points. Finally, all patients showed sensory improvement after decompression with a mean follow-up time of 18 months. Conclusion: The pudendal nerve is susceptible to compression at the passage from Alcocks canal to the dorsum of the penis. Diabetic patients with peripheral neuropathy can suffer from additional compression neuropathy with decreased penile sensibility and will benefit from a decompression of the pudendal nerve.