Shafik A
Department of Surgery and Experimental Research, Faculty of Medicine, Cairo University, Egypt.
Curr Opin Obstet Gynecol. 2000 Oct;12(5):387-98. doi: 10.1097/00001703-200010000-00008.
The present review describes the neuronal innervation of the external urethral and anal sphincters. A knowledge of this innervation helps in understanding the clinical symptoms of urinary and anorectal pathology, and in choosing the appropriate technique of nerve localization or block. An ability to locate the pudendal nerve, on the basis of surgically documented anatomy, has important diagnostic and therapeutic advantages. It can be used to study the integrity of pelvic floor muscles, in biofeedback training, nerve blocks, pudendal canal decompression, chronic stimulation trials to treat urinary or faecal incontinence, and in nerve conduction studies or evoked potential recordings. Furthermore, the superficial location of the sphincteric innervation in the perineum and ischiorectal fossa renders the nerve branches susceptible to injury during operative correction of urinary or faecal incontinence. Supported by a knowledge of anatomy, we can make firm recommendations on which to base safe surgical techniques that avoid damage to urethral and anal sphincteric innervation.
本综述描述了尿道外括约肌和肛门括约肌的神经支配。了解这种神经支配有助于理解泌尿和肛肠疾病的临床症状，并有助于选择合适的神经定位或阻滞技术。基于手术记录的解剖结构来定位阴部神经的能力具有重要的诊断和治疗优势。它可用于研究盆底肌肉的完整性、生物反馈训练、神经阻滞、阴部管减压、治疗尿失禁或大便失禁的慢性刺激试验，以及神经传导研究或诱发电位记录。此外，括约肌神经支配在会阴和坐骨直肠窝的浅表位置使神经分支在尿失禁或大便失禁的手术矫正过程中易受损伤。在解剖学知识的支持下，我们可以提出可靠的建议，在此基础上制定安全的手术技术，避免损伤尿道和肛门括约肌的神经支配。
