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질분만에 따른 음부신경 손상 및 그 회복 양상

Pudendal Nerve Damage and Its Recovery in Vaginal Delivers

대한대장항문학회지 1997년 13권 1호 p.63 ~ 69
이상전 ( Lee Sang-Jeon ) - 충북대학교 의과대학 외과학교실

박진우 ( Park Jin-Woo ) - 충북대학교 의과대학 외과학교실

Abstract


We performed anorectal physiologic studies to evaluate the pelvic floor musculature and its innervation in 73 pregnant women(35 primiparous, 38 multiparous) who had been recruited into a study of pudendal nerve damage and its recovery in vaginal delivery as part of a prospective investigation. These women had all delivered by vaginal route with pros terolateral episiotomy. Pudendal nerve terminal motor latency was significantly increased 2∼3 days after delivery but substantial recovery occurred in the first 2 months after delivery nearly to the pre-delivery value. Maximum average resting pressure was not affected by delivery. In contrast, maximum average squeeze pressure was decreased significantly 2 ∼3 days after delivery and some recovery occurred in the first 6 months after delivery, which still remained significantly low relative to pre-delivery value. Perineal descent was significantly increased 2∼3 days after delivery but substantial
recovery occurred in the first 2 months after delivery, which still remained significantly low relative to pre-delivery value and thereafter no significant recovery was found. These results suggest pudendal nerve damage occurrs during vaginal delivery which recovers in the first 2 months after delivery but functional disturbance in pelvic floor sphincter muscuature persists thereafter, and we support avoidance of further vaginal delivery after previous damage to the innervation of pelvic floor sphincter musculature.

키워드

Pudendal Nerve;Vaginal delivery
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