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However, the nerve damage results in disruption to the nerve signals and therefore there is an inability to relax the anal sphincters and defecate, often leading to constipation. [5] An upper motor neuron lesion is one that is above the conus medullaris of the spinal cord and therefore above vertebral level T12. [13]
Treatment of pudendal nerve entrapment by nerve block is not often prescribed due to discomfort as well as the risk of injuring critical structures." [ 37 ] The expert consensus panel found no evidence for the use of pudendal nerve blocks as a treatment modality, either with corticosteroid or as local anesthetic alone.
This caused autonomic nerve damage resulting in constipation and obstructed defecation after the surgery. [61] Ventral rectopexy was developed in 2004 as a modification which would not destroy these nerves, since only the ventral/anterior surface (the front surface) is mobilized. [ 61 ]
The pudendal nerve is the main nerve of the perineum. [1]: 274 It is a mixed (motor and sensory) nerve and also conveys sympathetic autonomic fibers.It carries sensation from the external genitalia of both sexes and the skin around the anus and perineum, as well as the motor supply to various pelvic muscles, including the male or female external urethral sphincter and the external anal sphincter.
Constipation is more concerning when there is weight loss or anemia, blood is present in the stool, there is a history of inflammatory bowel disease or colon cancer in a person's family, or it is of new onset in someone who is older. [12] Treatment of constipation depends on the underlying cause and the duration that it has been present. [4]
Secondary constipation, which is due to another cause, such as chronic conditions, like Type 2 diabetes, poor dietary choices or neurological conditions that may impact intestinal motility
The pudendal nerve is especially vulnerable to irreversible damage, (stretch-induced pudendal neuropathy) which can occur with a 12% stretch. [2] If the pelvic floor muscles lose their innervation, they cease to contract and their muscle fibres are in time replaced by fibrous tissue, which is associated with pelvic floor weakness and incontinence.
The nerve roots from L4–S4 join in the sacral plexus which affects the sciatic nerve, which travels caudally (toward the feet). Compression, trauma or other damage to this region of the spinal canal can result in cauda equina syndrome. [citation needed] The symptoms may also appear as a temporary side-effect of a sacral extra-dural injection. [9]
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