Mini State of the Art: Regenerative Electrical Stimulation for Postpartum Pudendal Nerve Neuropathy

Vaginal birth is associated with injury to the pudendal nerves via stretch or compression by the fetal head. Vaginal birth, especially operative delivery, is an established risk factor for future development of pelvic floor disorders, including urinary and anal incontinence and pelvic organ prolapse. This association is likely related to neurologic injury at the time of obstetric delivery. As obstetric trauma is an inciting factor for the development of pelvic floor disorders, the postpartum period presents a possible time frame for prophylactic interventions. Twenty years ago, there was renewed interest in the electrical stimulation of peripheral nerves when the procedure was demonstrated to increase regeneration-associated genes and accelerate the anatomical and functional regeneration of injured nerves. Since then, preclinical studies have clarified the regeneration mechanism via electrical stimulation, and clinical studies have shown improved sensory and motor recovery. In this talk, we will review the evidence for electrical stimulation for pudendal nerve regeneration as a potential postpartum preventative therapy for pelvic floor disorders.