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Neurogenic Trauma During Delivery

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Pelvic Floor Disorders

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Abstract

One in four women will develop a pelvic floor disorder during their lifetime, and one in five will undergo surgery for prolapse or urinary incontinence. Pregnancy and childbirth are well-established risk factors for developing pelvic floor disorders. In fact, up to one third of women develop stress urinary incontinence after their first delivery, and 42% if those whose symptoms resolve in the first few months postpartum will have recurrent symptoms within 5 years.

Numerous translational studies going back as far as the 1980s support neurologic trauma to the pelvic floor muscles and striated urethral sphincter muscles as one mechanism by which pregnancy and delivery lead to pelvic floor disorders. There is also substantial evidence that anatomic injury to the pelvic musculature plays a significant role in postpartum pelvic floor disorders, including disruptions of the anal sphincter muscles and detachment of the levator ani from the pubic bones.

The pudendal nerve is susceptible to compression and stretch injury during childbirth as it travels through the fixed point of Alcock’s canal in the pelvis. Neurogenic trauma to the pudendal nerve primarily impacts three important pelvic floor structures: the striated urethral sphincter, external anal sphincter, and levator ani muscles.

The aim of this chapter is to explore the role of neurogenic trauma during delivery and its impact on pelvic floor function.

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Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Female Pelvic Medicine and Reconstructive Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Kimberly Kenton & Julia Geynisman-Tan

Authors
  1. Kimberly Kenton
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  2. Julia Geynisman-Tan
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Corresponding author

Correspondence to Kimberly Kenton .

Editor information

Editors and Affiliations

  1. Tertiary Referral Pelvic Floor and Incontinence Center, IV°Division of General Surgery, Regional Hospital, Treviso, University of Padua, Padua, Italy

    Giulio A. Santoro

  2. Department of Pediatric Radiology, Medical University of Lublin, Children’s University Hospital, Lublin, Poland

    Andrzej P. Wieczorek

  3. Urogynaecology and Pelvic Floor, Reconstruction Unit, Croydon University Hospital, St George’s University of London, London, UK

    Abdul H. Sultan

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Kenton, K., Geynisman-Tan, J. (2021). Neurogenic Trauma During Delivery. In: Santoro, G.A., Wieczorek, A.P., Sultan, A.H. (eds) Pelvic Floor Disorders. Springer, Cham. https://doi.org/10.1007/978-3-030-40862-6_14

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  • DOI: https://doi.org/10.1007/978-3-030-40862-6_14

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-40861-9

  • Online ISBN: 978-3-030-40862-6

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