Lesions of peripheral nerves in obstetrics and gynecology. A review

Česká verzia

Authors: E. Ehler ¹; M. Košťál ²
Authors place of work: Neurologická klinika PKN, a. s., a FZS UPa, přednosta doc. MUDr. E. Ehler, CSc. ¹; Porodnicko-gynekologická klinika PKN, a. s., a FZS UPa, přednosta doc. MUDr. M. Košťál, CSc. ²
Published in the journal: Ceska Gynekol 2010; 75(5): 423-428

Summary

Peripheral nerves in obstetrics and gynecology are damaged with moderate frequency. Mostly there are iatrogenic lesions, that most often develope during delivery, operations and also in course of smaller invasive procedures. In genitofemoral nerve lesions neuralgic pain in groin and vulva is the most striking symptom, in cutaneus femoris lateralis nerve damage there are unpleasant paresthesias of lateral thigh. In case of femoral or obturator nerve lesion a weakness of thigh muscles with difficulties of standing and walking is the most typical. In pudendal nerve damage the autonomic disturbances (incontinence of feaces and urine) and pain in perineum are in the foreground of the patient’s complains. After a knowledgeable history taking and detailed clinical examination the next step of diagnostics are neurophysiological investigations (neurography and needle electomyography). In special cases there is racional to use imaging methods (ultrasonography, MRI, CT). In majority of these iatrogennic nerve lesions the conservative approach is successful (rehabilitation, medicaments against neuropathic pain) and only in a small proportion of patients the neurosurgeon consultation is necessary.

Key words:
delivery, gynecological operations, iatrogenic lesions, peripheral nerves, electromyography.

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