A man with urinary incontinence after a pelvic fracture likely sustained additional injury to which nerve?

In the context of urinary incontinence following a pelvic fracture, the injury to the pelvic nerves is especially significant due to their role in bladder control and urinary function. The pelvic nerves are responsible for the parasympathetic innervation of the bladder, facilitating bladder contraction and the sensation of bladder fullness. An injury to the pelvic nerves can disrupt these functions, leading to incontinence.

Pelvic fractures can cause damage to the structures in the pelvic region, including associated nerves. Given that the pelvic nerves are critical for the autonomic control of the bladder, damage to them as a result of fracture could easily lead to incontinence symptoms.

In contrast, other nerves mentioned, such as the pudendal nerve, primarily provide somatic innervation to the external urinary sphincter and the perineum. While damage to the pudendal nerve can also lead to urinary incontinence, it is less commonly involved in cases related to pelvic fractures compared to the pelvic nerves themselves. The hypogastric nerve is part of the sympathetic nervous system and is more involved in bladder filling rather than emptying, making it less relevant in the context of this specific scenario.