Seen in Shy-Drager syndrome, Charct-Marie-Tooth disease, Orthostatic hypotension.
Suspected autonomic denervation related to injuries to the branches of pelvic plexi eventually causing endometriosis, adenomyosis, vulvodynia, dyspareunia, irritative bladder and bowel symptoms.
Plexi injuries are a result of difficult first labor, minor GYN surgical procedures that require traction to the uterine cervix, vigorous curettage, and persistent straining during bowel movements.
In the above setting latent years of 10-15 years between the primary injury and clinical presentation may occur, and it depends on the site, nature, and extent of neurologic damage.
It is suggested that neurological injury to branches of pelvic plexi, celiac nerves and cardiac plexi may contribute to clinical conditions presenting as autonomic denervation.