Nerve injury during Pelvic Floor Repair Article

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Nerve injury during Pelvic Floor Repair Article

Postby Amanda » Mon Sep 06, 2010 10:52 pm

Possible nerve injury during pelvic floor repair


Int Urogynecol J Pelvic Floor Dysfunct. 2006 Nov;17(6):642-5. Epub 2006 May 30. Links
Relationship of the uterosacral ligament to the sacral plexus and to the pudendal nerve.Siddique SA, Gutman RE, Schon Ybarra MA, Rojas F, Handa VL.
Department of Gynecology and Obstetrics, Johns Hopkins Bayview Medical Center, 4940 Eastern Avenue, Building A, Rm 121, Baltimore, MD, 21224, USA.

We describe the anatomy of the uterosacral ligament with respect to the sacral plexus. In six adult female embalmed cadavers, we identified the uterosacral ligament and its lateral nerve relations. Using the ischial spine as the starting point and measuring along the axis of the uterosacral ligament, we noted that the S1 trunk of the sacral plexus passes under the ligament 3.9 cm [95% confidence interval (CI), 2.1-5.8 cm] superior to the ischial spine. The S2 trunk passes under the ligament at 2.6 cm (95% CI; 1.5, 3.6 cm), the S3 trunk passes under the ligament at 1.5 cm (95% CI; 0.7, 2.4 cm), and the S4 trunk passes under the ligament at 0.9 cm (95% CI; 0.3, 1.5 cm) superior to the ischial spine. The pudendal nerve forms lateral to the uterosacral ligament. Our data demonstrate that the S1-S4 trunks of the sacral plexus, not the pudendal nerve, are vulnerable to injury during uterosacral ligament suspension.

PMID: 16733625 [PubMed - in process]
PNE started 2003 following Vaginal Hysterectomy, pelvic floor repair and right oophorectomy; eventually after many tests had BilateralTG surgery Nantes 2004; following this tried many other treatments including 7 day epidural, ketamin infusions to no avail; Trialed and was implanted with a Neurostimulator in 2007- Dr Van Buyten Belgium, this has enabled me to manage my pain much better.
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