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Marc Possover, Karl-Erik Andersson, Axel Forman
Chronic pelvic pain (CPP) is a common condition involving multiple, organ-specific medical specialties, each with its own approach to diagnosis and treatment. Management requires knowledge of the interplay between pelvic organ function and neuro-functional anatomy, and of the neurologic and psychological aspects of CPP, but no current specialty fully encompasses this approach. Neuropelveology is an emerging discipline focusing on pathologies of the pelvic nervous system on a cross-disciplinary basis. It involves a neurological/neurosurgical approach, combining the knowledge required for a proper neurologic diagnosis, confirmation by transvaginal/transrectal examination of the pelvic nerves, and advanced laparoscopic surgery in selected cases of CPP...
December 2017: International Neurourology Journal
Young Sam Cho
No abstract text is available yet for this article.
December 2017: International Neurourology Journal
Marc Possover
OBJECTIVE: To report neurologic follow-up of patients after laparoscopic large resection of deep infiltrating endometriosis of the sciatic nerve. DESIGN: Prospective clinical case series. SETTING: Tertiary referral unit specializing in advanced gynecologic surgery and neuropelveology. PATIENTS: All data for patients who underwent laparoscopic surgery for endometriosis of the sciatic nerve between 2004 and 2016 (n = 259) were documented prospectively...
July 2017: Journal of Minimally Invasive Gynecology
Nucelio Lemos, Marc Possover
It is long known that a large portion of the lumbosacral plexus is located intra-abdominally, in the retroperitoneal space. However, most of literature descriptions of lesions on this plexus refer to its extra-abdominal parts whereas its intra-abdominal portions are often neglected. The objective of this review article is to describe the laparoscopic anatomy of intrapelvic nerve bundles, as well as the findings and advances already achieved by Neuropelveology practitioners.
July 2015: Journal of Hip Preservation Surgery
Marc Possover, Axel Forman
BACKGROUND: Some patients have pelvic, pudendal, or low lumbar pain radiating into the legs that is worse while sitting but differs from pudendal neuralgia. The purpose of this study was to present a new clinical entity of neuropathic pelvic pain by pelvic neuro-vascular entrapment. OBJECTIVES: To report about the locations of predilection for pelvic neurovascular entrapment. STUDY DESIGN: Prospective cohort pre- and post-intervention. SETTING: University referral unit specializing in advanced gynecological surgery and neuropelveology...
November 2015: Pain Physician
Marc Possover, Axel Forman, Benoit Rabischong, Nucelio Lemos, Vito Chiantera
No abstract text is available yet for this article.
November 2015: Journal of Minimally Invasive Gynecology
Alysson Zanatta, Mateus M Rosin, Ricardo L Machado, Leonardo Cava, Marc Possover
STUDY OBJECTIVE: To demonstrate the technique of laparoscopic dissection for identification of sacral nerve roots and pelvic splanchnic nerves. DESIGN: Case report (Canadian Task Force classification III). SETTING: Private practice hospital in São Paulo, Brazil. PATIENT: A 31-year-old woman with suspected iatrogenic and/or compression of sacral nerve roots. She reported debilitating pelvic, gluteal, and perineal unilateral left-sided pain (score 8 on a pain scale of 0-10), and had primary infertility with 1 previous failed attempt at in vitro fertilization...
November 2014: Journal of Minimally Invasive Gynecology
Marc Possover
Herein is described laparoscopic implantation of a neuroprosthesis to the pudendal nerve for treatment of non-neurogenic bladder overactivity. This case series study was performed at a tertiary referral unit that specializes in advanced gynecologic surgery and neuropelveology. Fourteen consecutive male and female patients underwent laparoscopic implantation of an electrode to the endopelvic portion of the pudendal nerve for pudendal neuromodulation. All procedures were performed successfully via laparoscopy, without any complications...
September 2014: Journal of Minimally Invasive Gynecology
Marc Possover
OBJECTIVE: To investigate pathophysiologic mechanisms involved in bladder retention after surgery for rectovaginal deeply infiltrating endometriosis (DIE). DESIGN: Retrospective case study. SETTING: Tertiary referral unit. PATIENT(S): All patients who presented at our center over the last 5 years with bladder retention developed after laparoscopic surgery for rectovaginal or parametric DIE. INTERVENTION(S): To assess the mechanisms involved in the pathogenesis of this complaint, we performed a step-by-step workup including patient history, clinical neuropelveologic assessment, cystoscopy, and video-urodynamic testing with pelvic floor electromyography and rectomanometry...
March 2014: Fertility and Sterility
Marc Possover
OBJECTIVE: To report on unexpected findings in 4 patients with chronic paraplegia who underwent the laparoscopic implantation of neuroprosthesis procedure in the pelvic lumbosacral nerves. DESIGN: Observational case series. SETTING: Tertiary referral unit specialized in advanced gynecological surgery and neuropelveology. PARTICIPANTS: Three patients with incomplete American Spinal Injury Association (ASIA) Impairment Scale (AIS) grade B (n=2) and AIS grade C (n=1) spinal cord injury (SCI) and 1 patient with flaccid complete chronic SCI (AIS grade A) (n=1)...
April 2014: Archives of Physical Medicine and Rehabilitation
Marc Possover, Thilo Schneider, Klaus-Peter Henle
OBJECTIVE: To report our experience with endopelvic causes for sacral radiculopathies and sciatica. DESIGN: Prospective cohort study. SETTING: Tertiary referral advanced laparoscopic gynecology and neuropelveologic unit. PATIENT(S): Two hundred thirteen women who underwent laparoscopic management of sacral radiculopathy (sciatica, pudendal, gluteal pain) of unknown genesis in the period between November 2004 and February 2010...
February 2011: Fertility and Sterility
Marc Possover
Neurophysiological investigations and neurosurgical procedures of the sacral plexus are not especially well developed, because the sacral plexus is difficult to access. Awareness that sacral radiculopathies may exist is still lacking and the incidence of these pathologies is widely underestimated. Since the recent introduction of laparoscopy in the field of pelvic nerves, the situation has changed considerably: laparoscopy not only permits a precise morphological and functional exploration of the entire sacral plexus, but also offers new therapeutic options: In lesions to the sacral nerve roots by compression, infiltration, or surgical damages, the laparoscopy offers an adequate access for micro-neurosurgical procedures; whereas in neurogenic pathologies or situations of failure of neurosurgical treatments, the technique of laparoscopic implantation of a neuroprosthesis - the LION procedure - permits the neuromodulation of all sacral nerve roots in different combination with only one electrode for simultaneous control of pelvic/lower limb pain and pelvic visceral dysfunctions...
April 2010: Surgical Technology International
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