A 21-year-old woman presented to the clinic one week after a normal vaginal delivery. The delivery had a prolonged second stage of labor and was complicated by perineal laceration. During the past week, the patient had recurrent pelvic pain, that is responsive to analgesics. In addition, she reports a few times of fecal incontinence. The patient has a free previous medical and surgical history. Physical examination shows the perineal laceration is healing well with no drainage. There is decreased anal sphincter tone and loss of the anocutaneous reflex. Neurological examination is otherwise normal. Which of the following is the cause of this patient's incontinence?

Question

Quizplus · Accepted Answer

Eductional Objective: Labor stresses the pelvic floor muscles, excessive stretching and stress may damage the pudendal nerve. The pudendal nerve injury may manifest with perineal muscles weakness that could present with fecal incontinence.

A 21-Year-Old Woman Presented to the Clinic One Week After