Obstetric injuries and subsequent gynaecological presentations

Thank you for giving us the opportunity to comment on Dr Quinn’s interesting letter. It is plausible that levator trauma may be associated with chronic pelvic pain as a result of childbirth. This needs to be studied in the future as, for the time being, we only have anecdotal evidence. We have not been able to describe concurrent injuries to the uterosacral ligaments and pelvic nerves as these structures are not visualised on four-dimensional translabial ultrasound imaging.