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Pelvic nerve damage

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https://www.readbyqxmd.com/read/29744050/iatrogenic-nerve-lesion-following-laparoscopic-surgery-a-case-report
#1
Michele Vecchio, Andrea Santamato, Fortunato Geneovese, Giulia Malaguarnera, Vito Emanuele Catania, Saverio Latteri
Background: Peripheral neuropathy after surgical treatment is an under recognized potential untoward event. Pelvic surgery may be associated with nerve lesions by essentially three main mechanisms: transection, entrapment and pressure-stretching; the latter is the modality most frequently linked to patient's positioning on the operating room table. Presentation of the case: A 25 years old woman, after undergoing a laparoscopic gynaecologic procedure lasted >3 hours, on postoperative day one presented with numbness over her lateral right leg and dorsum of the foot, right foot drop and gait instability due to compression-stretching of the right superficial peroneal nerve...
April 2018: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/29742860/essential-anatomy-of-the-anorectum-for-colorectal-surgeons-focused-on-the-gross-anatomy-and-histologic-findings
#2
REVIEW
Jong Min Lee, Nam Kyu Kim
The anorectum is a region with a very complex structure, and surgery for benign or malignant disease of the anorectum is impossible without accurate anatomical knowledge. The conjoined longitudinal muscle consists of smooth muscle from the longitudinal muscle of the rectum and the striate muscle from the levator ani and helps maintain continence; the rectourethralis muscle is connected directly to the conjoined longitudinal muscle at the top of the external anal sphincter. Preserving the rectourethralis muscle without damage to the carvernous nerve or veins passing through it when the abdominoperineal resection is implemented is important...
April 2018: Annals of Coloproctology
https://www.readbyqxmd.com/read/29435745/a-step-towards-stereotactic-navigation-during-pelvic-surgery-3d-nerve-topography
#3
A R Wijsmuller, C Giraudeau, J Leroy, G J Kleinrensink, E Rociu, L G Romagnolo, A G F Melani, V Agnus, M Diana, L Soler, B Dallemagne, J Marescaux, D Mutter
BACKGROUND: Long-term morbidity after multimodal treatment for rectal cancer is suggested to be mainly made up by nerve-injury-related dysfunctions. Stereotactic navigation for rectal surgery was shown to be feasible and will be facilitated by highlighting structures at risk of iatrogenic damage. The aim of this study was to investigate the ability to make a 3D map of the pelvic nerves with magnetic resonance imaging (MRI). METHODS: A systematic review was performed to identify a main positional reference for each pelvic nerve and plexus...
February 12, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29259207/dickkopf2-rescues-erectile-function-by-enhancing-penile-neurovascular-regeneration-in-a-mouse-model-of-cavernous-nerve-injury
#4
Kalyan Ghatak, Guo Nan Yin, Min-Ji Choi, Anita Limanjaya, Nguyen Nhat Minh, Jiyeon Ock, Kang-Moon Song, Dong Hyuk Kang, Young-Guen Kwon, Ho Min Kim, Ji-Kan Ryu, Jun-Kyu Suh
Penile erection is a neurovascular event and neurologic or vascular disturbances are major causes of erectile dysfunction (ED). Radical prostatectomy for prostate cancer not only induces cavernous nerve injury (CNI) but also results in cavernous angiopathy, which is responsible for poor responsiveness to oral phosphodiesterase-5 inhibitors. Dickkopf2 (DKK2) is known as a Wnt signaling antagonist and is reported to promote mature and stable blood vessel formation. Here, we demonstrated in CNI mice that overexpression of DKK2 by administering DKK2 protein or by using DKK2-Tg mice successfully restored erectile function: this recovery was accompanied by enhanced neural regeneration through the secretion of neurotrophic factors, and restoration of cavernous endothelial cell and pericyte content...
December 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29238102/prevention-and-prediction-of-postoperative-bowel-bladder-disorder-using-an-anal-plug-electrode-with-tc-msep-monitoring-during-spine-surgery
#5
Kazuyoshi Kobayashi, Kei Ando, Hideki Yagi, Kenyu Ito, Mikito Tsushima, Masayoshi Morozumi, Satoshi Tanaka, Masaaki Machino, Kyotaro Ota, Yukihiro Matsuyama, Naoki Ishiguro, Shiro Imagama
A retrospective study was performed to examine the efficacy of intraoperative monitoring of the external anal sphincter (EAS) muscle-evoked potential after a transcranial muscle-action potential (Tc-MsEP) in spinal cord surgery, and to evaluate alarm points for EAS waveform deterioration related to postoperative bowel bladder disorder (BBD). BBD is caused by damage to the hypogastric, pelvic, and pudendal nerves and leads to a significant reduction in quality of life. Intraoperative Tc-MsEP monitoring using the EAS is common to prevent neurological deficit, but the relationship of BBD with intraoperative monitoring of the EAS has not been examined...
November 2017: Nagoya Journal of Medical Science
https://www.readbyqxmd.com/read/29201608/toward-bioelectronic-medicine-neuromodulation-of-small-peripheral-nerves-using-flexible-neural-clip
#6
Sanghoon Lee, Wendy Yen Xian Peh, Jiahui Wang, Fengyuan Yang, John S Ho, Nitish V Thakor, Shih-Cheng Yen, Chengkuo Lee
Neural modulation technology and the capability to affect organ function have spawned the new field of bioelectronic medicine. Therapeutic interventions depend on wireless bioelectronic neural interfaces that can conformally and easily attach to small (few hundred micrometers) nerves located deep in the body without neural damage. Besides size, factors like flexibility and compliance to attach and adapt to visceral nerves associated moving organs are of paramount importance and have not been previously addressed...
November 2017: Advanced Science (Weinheim, Baden-Wurttemberg, Germany)
https://www.readbyqxmd.com/read/29162245/ultrasound-guided-supra-acetabular-pin-placement-in-pelvic-external-fixation-description-of-a-surgical-technique-and-results
#7
Francisco Chana-Rodríguez, Manuel Cuervas-Mons, José Rojo-Manaute, Félix Mora, Juan Arnal, Javier Vaquero-Martín
INTRODUCTION: Pelvic fracture in trauma patients can lead to hemodynamic instability. External fixation is a treatment capable of stabilizing these injuries in the context of damage control surgery. Supra-acetabular pin offers the greater biomechanical stability but requires the use of intraoperative fluoroscopy. The aim of this study was to analyze our results for an ultrasound-guided supra-acetabular pinning. MATERIAL AND METHODS: Cross-sectional study with cadaveric specimens...
November 2017: Injury
https://www.readbyqxmd.com/read/29159162/electrophysiological-basis-of-fecal-incontinence-and-its-implications-for-treatment
#8
REVIEW
Elroy Patrick Weledji
The majority of patients with neuropathic incontinence and other pelvic floor conditions associated with straining at stool have damage to the pudendal nerves distal to the ischial spine. Sacral nerve stimulation appears to be a promising innovation and has been widely adopted and currently considered the standard of care for adults with moderate to severe fecal incontinence and following failed sphincter repair. From a decision-to-treat perspective, the short-term efficacy is good (70%-80%), but the long-term efficacy of sacral nerve stimulation is around 50%...
October 2017: Annals of Coloproctology
https://www.readbyqxmd.com/read/29144006/behavioral-outcomes-of-a-novel-pelvic-nerve-damage-rat-model-of-fecal-incontinence
#9
P T J Janssen, S O Breukink, J Melenhorst, L P S Stassen, N D Bouvy, Y Temel, A Jahanshahi
BACKGROUND: Fecal incontinence (FI) has a multifactorial pathophysiology with a severe social impact. The most common cause for FI is pudendal nerve damage, which mostly occurs in women during or after labor. A better understanding of the pathophysiology is required to optimize treatment of FI. In this study, we evaluate the use of a novel pelvic nerve damage rat model of FI. METHODS: This new model simulates the forces on the pelvic floor during labor by prolonged transvaginal, retro-uterine intrapelvic balloon distention in female rats...
November 16, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29137943/cystoscopic-assisted-laparoscopic-excision-of-prostatic-utricle
#10
Ibrahim A Mostafa, Mark N Woodward, Mohamed S Shalaby
We present a video of our technique for resection of a large prostatic utricle (PU) in a patient who presented initially with disordered sexual development. His karyotype was 46XY, and phenotypically had penoscrotal hypospadias, bifid scrotum, and retractile right testis. An initial micturating cystourethrogram (MCUG) demonstrated the utricle but failed to cannulate the bladder. Being asymptomatic, we carried out staged repair of his hypospadias. Later, he started to have recurrent epididymo-orchitis with resistance to multiple antibiotics...
October 27, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29135610/meralgia-paresthetica-after-spine-surgery-on-the-jackson-table
#11
Nitin Agarwal, Jaydev B Mistry, Preeya V Khandge, David R Hansberry, Ira M Goldstein
Meralgia paresthetica is a non-life-threatening neurological disorder characterized by numbness, tingling, and burning pain over the anterolateral thigh due to impingement of the lateral femoral cutaneous nerve. This disorder has been seen in patients with diabetes mellitus and obesity, but has also been observed in patients after procedures such as posterior spine surgery, iliac crest bone grafts, lumbar disk surgery, hernia repair, appendectomies, and pelvic osteotomies that ultimately lead to compression or damage to the lateral femoral cutaneous nerve...
March 2018: Clinical Spine Surgery
https://www.readbyqxmd.com/read/29130653/-advances-in-diagnosis-and-treatment-of-posterior-distal-injury-of-pelvic-fracture
#12
REVIEW
Zhen Tan, Guang-Lin Wang
Pelvic fracture is one of the common diseases of traumatic orthopedics. With the increase of accidents such as traffic accidents,high craters and crush injuries in China,the incidence of pelvic fractures is also increasing year by year. Since pelvic bones and the ligament structure are close to neurovascular,cavity organs and the urogenital structure,early diagnosis and treatment of pelvic fractures is essential for preventing early complications and late sequelae. The treatment of pelvic ring injury has been the focus of pelvic fracture treatment,which determines the outcome of treatment...
September 2017: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
https://www.readbyqxmd.com/read/29099379/-complications-of-radical-prostatectomy
#13
REVIEW
Cristina Redondo, François Rozet, Guillermo Velilla, Rafael Sánchez-Salas, Xavier Cathelineau
OBJECTIVES: The aim of this article is to classify and describe the different types of complications of radical prostatectomy, their frequency of appearance, as well as the different factors that may influence their development. METHODS: A systematic review of the literature was carried out, based on the search of published articles between 2002 and 2015. RESULTS: Laparoscopic or robotic radical prostatectomy may require conversion into open surgery, and these cases are significantly associated with longer hospital stay and greater rate of complications...
November 2017: Archivos Españoles de Urología
https://www.readbyqxmd.com/read/29016507/cadaveric-nerve-and-artery-proximity-to-sacrospinous-ligament-fixation-sutures-placed-by-a-suture-capturing-device
#14
Aaron Z Katrikh, Rajuno Ettarh, Margie A Kahn
OBJECTIVE: To simulate sacrospinous ligament fixation on cadaveric specimens, describe the surrounding retroperitoneal anatomy, and estimate the risk to nerves and arteries for the purposes of optimizing safe suture placement. METHODS: Sacrospinous ligament fixation was performed on eight fresh-tissue female cadavers using a Capio ligature capture device. Distances from placed sutures to the following structures were measured: ischial spine; fourth sacral root; pudendal nerve; the nerve to coccygeus muscle; the nerve to levator ani muscle; inferior gluteal artery; and internal pudendal artery...
November 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28934542/complications-associated-with-pelvic-external-fixation
#15
Christopher McDonald, Reza Firoozabadi, M L Routt, Conor Kleweno
An external fixator is an essential tool for treating unstable pelvic ring injuries but its use carries risks, including pin-site infections and injury to the lateral femoral cutaneous nerve (LFCN). Surgeons currently lack data regarding these risks for patient counseling. This study aimed to identify the incidence of and risk factors for superficial and deep pin-site infection and LFCN damage. Fifty-two patients who underwent pelvic external fixation with anterior pin placement as part of definitive treatment for unstable pelvic ring disruption were retrospectively evaluated to identify factors associated with the development of infection...
November 1, 2017: Orthopedics
https://www.readbyqxmd.com/read/28838787/surgical-interventions-and-the-use-of-device-aided-therapy-for-the-treatment-of-fecal-incontinence-and-defecatory-disorders
#16
Adil E Bharucha, Satish S C Rao, Andrea S Shin
The purpose of this clinical practice update expert review is to describe the key principles in the use of surgical interventions and device-aided therapy for managing fecal incontinence (FI) and defecatory disorders. The best practices outlined in this review are based on relevant publications, including systematic reviews and expert opinion (when applicable). Best Practice Advice 1: A stepwise approach should be followed for management of FI. Conservative therapies (diet, fluids, techniques to improve evacuation, a bowel training program, management of diarrhea and constipation with diet and medications if necessary) will benefit approximately 25% of patients and should be tried first...
December 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28757357/erectile-dysfunction-following-pelvic-fracture-urethral-injury
#17
REVIEW
Niels V Johnsen, Melissa R Kaufman, Roger R Dmochowski, Douglas F Milam
INTRODUCTION: Although pelvic fracture urethral injuries (PFUIs) are rare, approximately half these patients will report erectile dysfunction (ED) after their injuries. The anatomic relations of the cavernosal nerves and arteries to the bones of the pelvis and the urethra put these structures at significant risk at the time of PFUI. This review examines the epidemiology, evaluation, and management of ED in this patient population. AIM: To evaluate the epidemiology, pathophysiology, diagnosis, and management of patients with ED after PFUI...
January 2018: Sexual Medicine Reviews
https://www.readbyqxmd.com/read/28725617/post-vasectomy-pain-syndrome-diagnosis-management-and-treatment-options
#18
REVIEW
Varsha Sinha, Ranjith Ramasamy
Vasectomy is the most effective form of sterilization for men. With approximately 500,000 vasectomies performed each year in the United States, 1-2% of these patients will experience chronic testicular pain for greater than three months after the procedure. Post-vasectomy pain syndrome (PVPS) is diagnosis of exclusion, and may be caused by direct damage to spermatic cord structures, compression of nerves in the spermatic cord via inflammation, back pressure from epididymal congestion, and perineural fibrosis...
May 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28689459/biomechanical-comparison-of-supraacetabular-external-fixation-and-anterior-pelvic-bridge-plating
#19
Ali Turgay Çavuşoğlu, Fatma Kübra Erbay, Mehmet Hakan Özsoy, Teyfik Demir
Unstable pelvic ring injuries are complex and risky injuries due to high morbidity and mortality. Although anterior pelvic external fixator is a suitable method for rapid stabilization of an injured pelvic ring, due to some disadvantages such as high complication rate, nerve damage, and difficulties of patient's mobility and comfort, there has recently been increased searching for alternative methods for stabilization of the pelvic ring. Pubic symphysis zone freely moves in pelvic models. This study aims to evaluate the biomechanical stability of anterior pelvic bridge plating and compare it with supraacetabular external fixators in an untreated unstable pelvic fracture model...
July 1, 2017: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/28681496/transcutaneous-sacral-nerve-stimulation-for-intraoperative-verification-of-internal-anal-sphincter-innervation
#20
D W Kauff, T Moszkowski, C Wegner, A Heimann, K-P Hoffmann, T B Krüger, H Lang, W Kneist
BACKGROUND: The current standard for pelvic intraoperative neuromonitoring (pIONM) is based on intermittent direct nerve stimulation. This study investigated the potential use of transcutaneous sacral nerve stimulation for non-invasive verification of pelvic autonomic nerves. METHODS: A consecutive series of six pigs underwent low anterior rectal resection. For transcutaneous sacral nerve stimulation, an array of ten electrodes (cathodes) was placed over the sacral foramina (S2 to S4)...
December 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
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