대한대장항문학회

Significant associations between perineal descent (PD) and pudendal nerve terminal motor<br>latency (PNTML) have previously been described in patients with fecal incontinence. This<br>had led to the hypothesis that pelvic floor muscle and nerve injury initiated by childbirth might<br>progress and cause fecal incontinence.<br>Purpose: This study was undertaken to evaluate the association between vaginal delivery<br>and PD, PNTML. Also, we evaluated the correlation between PD and PNTML.<br>Methods: Sixty one women who visited the Dept. of Surgery from Aug. 1998 to May. 1999<br>were randomly selected. Women were excluded, who had chronic constipation,operation<br>within 6 months before the investigation, anal trauma, diabetes mellitus, and neurologic<br>disease. They had a mean year of 43 12.5 years (range: 23∼70), a mean vaginal delivery<br>1.9 1.5 (range: 0∼6). PD at rest and during push, and PNTML were measured.<br>Results: PD during push (p=0.006) and the change of PD between at rest and during push<br>(p=0.003) were significantly increased with increasing number of vaginal deliveries. Rt<br>PNTML (p=0.08) and Lt PNTML (p=0.03) were significantly increased with increasing<br>number of vaginal deliveries. There was correlation between Lt PNTML and change of PD<br>(r=0.59, p=0.0).<br>Conclusions: PD and Lt PNTML was increased with repeated vaginal deliveries. Our<br>findings support the hypothesis that damage induced by vaginal delivery to pudendal nerve<br>and pelvic floor will progress.<br>