Denervation of pelvic organs taking place at vaginal delivery results in subsequent reinnervation and wide-ranging gynaecological symptoms e.g. vulvodynia, dyspareunia, chronic pelvic pain, irritative bladder symptoms, rectal hypersensitivity, menorrhagia and dysmenorrhoea (1-12). All benign myometrial pathology e.g. endometriosis, adenomyosis, leiomyomata, etc. has specific neural abnormalities in the spectrum of denervation-reinnervation (4-7). Reinnervation, in several different patterns, has been described in every female pelvic organ often in association with a prior history of difficult vaginal delivery including premature, or prolonged, maternal voluntary efforts (8-12).

In nulliparous women, straining to achieve defaecation has been demonstrated to cause specific neurological lesions in different pelvic viscera (8, 9, 12), and this mechanism, operating at the endometrial-myometrial nerve plexus , has been proposed as a source of impaired placentation in nulliparous pre-eclampsia. intrauterine growth retardation, abruption, placenta accrete/percreta (13, 14).

The question arises: "Do nulliparous women with severe obstetric problems e.g. early-onset preeclampsia. IUGR, preterm delivery, abruption, etc. suffer subsequent gynaecological symptoms e.g. menorrhagia, dysmenorrhoea, chronic pelvic pain, that require specific medical and surgical interventions e.g. hysteroscopy, laparoscopy, hysterectomy, etc. within the subsequent 10 years".