Question: “What are the risk factors for pelvic floor disorders, or nerve damage, and which nerves are affected?”
Answer from Dr. Daniel Gruber, urogynecologist from Sibley Memorial Hospital in Washington D.C., part of John Hopkins medicine.
There are many different risk factors, but the biggest one is pregnancy and delivery. Vaginal delivery is probably slightly more damaging to the pelvic nerves than a c-section, but just having the pregnancy itself is a risk factor.
The more babies somebody has, the larger the risk factor, but definitely having the first baby is usually the biggest risk factor. Large babies and damage during delivery can cause those things as well.
Other things that can influence, or have issues, with nerve damage are chronic constipation and/or chronic straining. That’s why it’s so important in our field to improve bowel control and to try to soften the stool so you’re not chronically straining.
Lifting heavy objects can do be a risk factor, too. If it’s just lifting once or twice, here and there, it’s not a big deal. But if somebody were working at UPS for example, and they lifted heavy boxes all day long, that could definitely have an impact.
The nerve specifically is the pudendal nerve, which comes around the bottom and has a distribution to the anal sphincter and some of the other vaginal superficial tissues, including the clitoris.
So, when that gets damaged, it can affect bowel control and people can develop accidental bowel leakage, where stool contents do come out and stay in the underwear. There’s a huge range of how often this occurs -it can happen once a month, two every day, and so on. You definitely should see us if that’s occurring. Find a pelvic floor specialist near you here.
