대한대장항문학회

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