The authors would like to thank O’Brien for his thoughtful review of an important topic relating to the short and long-term consequences and management of intrapartum injury of the pudendal nerves. Our clinical review has been constructed to provide evidence-based guidance for clinicians reviewing women with first and second-degree perineal trauma in the immediate postnatal period and not “post-partum morbidity” in general. Pudendal neuropathy is a complication that has a different pathogenesis to perineal trauma and, indeed, happen independent of the occurrence of a perineal tear. We agree that it is important that damage to the pudendal nerve is considered when women present with persistent, long-term pelvic floor complications, however, it is beyond the planned remit of our review.
Competing interests:
No competing interests
09 December 2014
Khaled MK Ismail
Professor of Obstetrics & Gynaecology
Sara Webb, Specialist Perineal Midwife; Margaret Sherburn, Women’s Health Specialist Physiotherapist
Birmingham Women’s NHS Foundation Trust, Birmingham, UK; 4Birmingham Centre for Women’s and Children’s Health, School of Clinical and Experimental Medicine, College of Medical and Dental Sciences, University of Birmingham, UK
Academic Unit, Birmingham Women’s NHS Foundation Trust, Birmingham B15 2TG, UK
Rapid Response:
The authors would like to thank O’Brien for his thoughtful review of an important topic relating to the short and long-term consequences and management of intrapartum injury of the pudendal nerves. Our clinical review has been constructed to provide evidence-based guidance for clinicians reviewing women with first and second-degree perineal trauma in the immediate postnatal period and not “post-partum morbidity” in general. Pudendal neuropathy is a complication that has a different pathogenesis to perineal trauma and, indeed, happen independent of the occurrence of a perineal tear. We agree that it is important that damage to the pudendal nerve is considered when women present with persistent, long-term pelvic floor complications, however, it is beyond the planned remit of our review.
Competing interests: No competing interests