This approach requires a small vaginal incision in women and a small incision between the anal area and scrotum for men. Usually the sacrospinous ligament is partially severed to relieve the compressed nerve but the sacrotuberous ligament is spared. To read more about his procedure click on this link: http://www.perineology.com/files/pne_bautrant.pdf It is best to contact him through e-mail. Dr. Eric Bautrant