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      Correlating structure and function: three-dimensional ultrasound of the urethral sphincter : 3D ultrasound of the urethral sphincter

      , , ,

      Ultrasound in Obstetrics and Gynecology

      Wiley-Blackwell

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          Pelvic floor damage and childbirth: a neurophysiological study.

          Ninety six nulliparous women were investigated to establish whether childbirth causes damage to the striated muscles and nerve supply of the pelvic floor. The techniques used were concentric needle electromyography (EMG), pudendal nerve conduction tests and assessment of pelvic floor contraction using a perineometer. There was EMG evidence of re-innervation in the pelvic floor muscles after vaginal delivery in 80% of those studied. Women who had a long active second stage of labour and heavier babies showed the most EMG evidence of nerve damage. Forceps delivery and perineal tears did not affect the degree of nerve damage seen. We conclude that vaginal delivery causes partial denervation of the pelvic floor (with consequent re-innervation) in most women having their first baby. In a few this is severe and is associated with urinary and faecal incontinence. For some it is likely to be the first step along a path leading to prolapse and/or stress incontinence.
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            Injury to innervation of pelvic floor sphincter musculature in childbirth.

            71 women delivered at St Bartholomew's Hospital, London, were studied by electrophysiological tests of the innervation of the external anal sphincter muscle and by manometry. The investigations were done 2-3 days after delivery and again, in 70% of these women, 2 months later. Faecal and urinary incontinence developing after vaginal delivery has been thought to be due to direct sphincter division, or muscle stretching, but the results of the study suggest that in most cases this incontinence results from damage to the innervation of the pelvic floor muscles.
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              The urethral pressure profile.

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                Author and article information

                Journal
                Ultrasound in Obstetrics and Gynecology
                Ultrasound Obstet Gynecol
                Wiley-Blackwell
                09607692
                March 2004
                March 25 2004
                : 23
                : 3
                : 272-276
                Article
                10.1002/uog.987
                © 2004

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