Episiotomy, bartholinitis
Reminder
- Explain chronic pain
- Cicatricial neuropathies
- Associated myofascial syndromes that modify the clinical symptoms of cicatricial neuropathies.
Description
The surgical approaches to these two procedures are vulvar for bartholinitis +/- perineal for episiotomy. We will recall the innervation of this area (in blue, the genitocrural nerve, in yellow, the cluneal nerve, in red the pudendal nerve):
During these two procedures, local neuropathic damage may be responsible for pain spreading along the path of the main nerve responsible for the operated area. In our experience, the most common involvement concerns the genitocrural nerve (upper diagram, underlying) and the cluneal nerve (lower diagram underlying), the pudendal nerve being more rarely affected:
The diagnosis is evoked on the presence of a trigger zone at the level of the scars.