Snooks S J, Swash M, Mathers S E, Henry M M
Sir Alan Parks Anorectal Physiology Laboratory, St. Mark's Hospital, London, UK.
Br J Surg. 1990 Dec;77(12):1358-60. doi: 10.1002/bjs.1800771213.
We have studied the pelvic floor musculature and its innervation in 14 of 24 (58 per cent) multiparous women who had been recruited into a study of the effect of childbirth on the pelvic floor as part of a prospective investigation that began in 1983. These 24 women had all delivered by the vaginal route without forceps assistance. Five of the 14 had developed clinical symptoms of stress incontinence 5 years later; two of them had had a further uncomplicated vaginal delivery during this time. There was manometric and neurophysiological evidence of weakness because of partial denervation of the pelvic floor striated sphincter musculature, with pudendal neuropathy, which was more marked in those women with incontinence. These findings provide direct evidence for the hypothesis that pudendal neuropathy due to vaginal delivery persists and may worsen with time.
我们对24名经产妇中的14名（58%）进行了盆底肌肉组织及其神经支配的研究。这些经产妇是1983年开始的一项前瞻性调查的一部分，该调查旨在研究分娩对盆底的影响。这24名女性均通过阴道分娩，未使用产钳辅助。14名女性中有5名在5年后出现了压力性尿失禁的临床症状；其中2名在此期间又经历了一次无并发症的阴道分娩。有压力测量和神经生理学证据表明，由于盆底横纹括约肌肌肉组织部分失神经支配以及阴部神经病变，导致了肌肉无力，这种情况在尿失禁女性中更为明显。这些发现为以下假设提供了直接证据：阴道分娩导致的阴部神经病变会持续存在，并可能随时间恶化。
