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Antenatal perineal massage (APM) or Birth Canal Widening (BCW) is the massage of a pregnant woman's perineum – the skin and deep tissues around the opening to the vagina (or 'birth canal' – when a baby is in this passage), performed in the 4 to 6 weeks before childbirth, i.e., 34 weeks or sooner (Reference 7, as more births are occurring at around 28 weeks) and continued weekly until birth.
Vaginal tears can occur during childbirth, most often at the introitus as the baby's head passes through, especially if the baby descends quickly. Episiotomies are used in an effort to prevent soft-tissue tearing (perineal tear) which may involve the anal sphincter and rectum. Tears can involve the perineal skin or extend to the muscles and the ...
The perineal branches are distributed to the skin at the upper and medial side of the thigh. The main part to the back of the thigh and leg consists of numerous filaments derived from both sides of the nerve, and distributed to the skin covering the back and medial side of the thigh, the popliteal fossa, and the upper part of the back of the leg.
The pain may be described as a burning, tingling, stabbing, or electric-shock like sensation and it is usually only affects one side of the body. [2] Pudendal neuralgia can arise from trauma, overuse, sports, surgery, radiation therapy , tumors, viruses (e.g. Herpes Zoster , HIV ), endometriosis , multiple sclerosis , pudendal nerve entrapment ...
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.
The perineal nerve is a branch of the pudendal nerve. [1] [2] It lies below the internal pudendal artery.It accompanies the perineal artery.It passes through the pudendal canal for around 2 or 3 cm. [1] [2] Whilst still in the canal, it divides into superficial branches and a deep branch. [1]
The perineal approach uses a small incision in the perineum between the anus and the ischial tuberosity. The nerve is freed within the pudendal canal. [10] The laparoscopic approach (Istanbul technique), also termed "laparoscopic pudendal nerve decompression and transposition with omental fap protection of the nerve," is relatively new.
A perineal tear is a laceration of the skin and other soft tissue structures which, in women, separate the vagina from the anus. Perineal tears mainly occur in women as a result of vaginal childbirth, which strains the perineum. It is the most common form of obstetric injury. [1] Tears vary widely in severity.