ABSTRACT
The peripheral nervous system is the end mediator for neuromuscular control of the lower urinary tract. As such, a thorough appreciation of the complex anatomy is required for the pelvic physician and surgeon. Such an understanding allows for optimized treatment approaches as well as expedient recognition of post-treatment injuries. This chapter discusses the relevant anatomy and syndromes occurring after pelvic surgery and/or pelvic radiation therapy and their management. Three main peripheral nerves innervate the pelvis, providing sensation and control to the bladder, urethra, pelvic floor, and external genitalia. While many surgeries of the retroperitoneum and spine may risk peripheral nerve injury, the chapter focuses on the procedures with the highest risk of causing lower urinary tract peripheral neuropathy. Lower urinary tract dysfunction is the most common long-term side effect of radical hysterectomy for cervical and uterine malignancy, with rates of 8%–80% depending on the limits of dissection.
