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Pelvic nerve damage

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https://www.readbyqxmd.com/read/29159162/electrophysiological-basis-of-fecal-incontinence-and-its-implications-for-treatment
#1
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
#2
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
#3
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
#4
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...
November 10, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/29130653/-advances-in-diagnosis-and-treatment-of-posterior-distal-injury-of-pelvic-fracture
#5
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
#6
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
#7
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
#8
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...
September 21, 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
#9
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
#10
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...
July 27, 2017: Sexual Medicine Reviews
https://www.readbyqxmd.com/read/28725617/post-vasectomy-pain-syndrome-diagnosis-management-and-treatment-options
#11
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
#12
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
#13
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)...
July 6, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28643303/-application-of-fascia-orientation-of-pelvic-autonomic-nerve-preservation-in-rectal-cancer-surgery
#14
Xiaobo Liang, Yi Wang, Guolong Ma
Rectal cancer has become the second most common gastrointestinal tumor in our country. With the development of comprehensive treatment, the long-term survival rate of patients with rectal cancer has greatly increased, meanwhile, higher postoperative quality of life is required. But the genitourinary dysfunction which is mainly caused by intraoperative pelvic autonomic nerve damage haunts postoperative rectal cancer patients. Traditional pelvic autonomic nerve protection technology born in the 1980s only improves urogenital function in a part of postoperative patients...
June 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28619043/effect-of-transcutaneous-electrical-stimulation-treatment-on-lower-urinary-tract-symptoms-after-class-iii-radical-hysterectomy-in-cervical-cancer-patients-study-protocol-for-a-multicentre-randomized-controlled-trial
#15
Xiu-Li Sun, Hai-Bo Wang, Zhi-Qi Wang, Ting-Ting Cao, Xin Yang, Jing-Song Han, Yang-Feng Wu, Kathleen H Reilly, Jian-Liu Wang
BACKGROUND: Class III radical hysterectomy (RH III)_plus pelvic lymphadenectomy is the standard surgery for early stage cervical cancer (CC) patients, the 5 year survival rate is about 90%, but pelvic floor disorders especially bladder dysfunction are common due to damaged vessels and nerve fibers following surgery. Transcutaneous electrical stimulation (TENS) treatment has been used to treat bladder disorders for many years, but its effect on cervical cancer patients, the best treatment time point and stimulated protocol, had never been assessed...
June 15, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28498243/a-controlled-study-on-vaginal-blood-flow-during-sexual-arousal-among-early-stage-cervical-cancer-survivors-treated-with-conventional-radical-or-nerve-sparing-surgery-with-or-without-radiotherapy
#16
Rinske Maria Bakker, Quirine D Pieterse, Luc R C W van Lonkhuijzen, Baptist J B M Z Trimbos, Carien L Creutzberg, Gemma G Kenter, Cor D de Kroon, Moniek M Ter Kuile
OBJECTIVE: Sexual problems among cervical cancer survivors may in part be caused by reduced vaginal blood flow due to damaged hypogastric nerves during radical hysterectomy with pelvic lymphadenectomy and/or by radiation-induced vaginal changes after pelvic radiotherapy. A nerve-sparing modification of radical hysterectomy (NSRH) may preserve vaginal blood flow. Vaginal blood flow during sexual arousal was compared between different treatment modalities. METHODS: We investigated premenopausal women treated for early-stage cervical cancer with radical hysterectomy (n = 29), NSRH (n = 28), NSRH with radiotherapy (n = 14), and controls (n = 31)...
June 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28481856/systematic-review-of-animal-models-used-in-research-of-origins-and-treatments-of-fecal-incontinence
#17
REVIEW
Judith Evers, James F X Jones, P Ronan O'Connell
BACKGROUND: Fecal incontinence is a common disorder, but its pathophysiology is not completely understood. OBJECTIVE: The aim of this review is to present animal models that have a place in the study of fecal incontinence. DATA SOURCES: A literature review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines performed in August 2016 revealed 50 articles of interest. Search terms included fecal/faecal incontinence and animal model or specific species...
June 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28255352/direct-administration-of-nerve-specific-contrast-to-improve-nerve-sparing-radical-prostatectomy
#18
Connor W Barth, Summer L Gibbs
Nerve damage remains a major morbidity following nerve sparing radical prostatectomy, significantly affecting quality of life post-surgery. Nerve-specific fluorescence guided surgery offers a potential solution by enhancing nerve visualization intraoperatively. However, the prostate is highly innervated and only the cavernous nerve structures require preservation to maintain continence and potency. Systemic administration of a nerve-specific fluorophore would lower nerve signal to background ratio (SBR) in vital nerve structures, making them difficult to distinguish from all nervous tissue in the pelvic region...
2017: Theranostics
https://www.readbyqxmd.com/read/28187094/extraperitoneal-radical-trachelectomy-with-pelvic-lymphadenectomy-a-novel-fertility-preserving-option-for-early-stage-cervical-cancer-patients
#19
Seiji Mabuchi, Tadashi Kimura
OBJECTIVE: Radical trachelectomy combined with pelvic lymphadenectomy has been used to treat early stage cervical cancer patients who wish to preserve their fertility. Although vaginal, abdominal, laparoscopic, and robotic approaches have been used during this procedure, all of these approaches cause peritoneal damage, which could result in periadnexal adhesion. The aim of the present study was to introduce and discuss a novel fertility-preserving option, extraperitoneal radical trachelectomy with pelvic lymphadenectomy...
March 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28142352/functional-outcome-of-patients-with-unstable-pelvic-ring-fracture
#20
Yasuo Kokubo, Hisashi Oki, Daisuke Sugita, Kenichi Takeno, Tsuyoshi Miyazaki, Kohei Negoro, Hideaki Nakajima
The purpose of this study was to evaluate factors that correlated with unsatisfactory short- and long-term outcome in patients who sustained unstable pelvic ring fracture. The study subjects of this study were those of type B and C pelvic ring fractures (82 patients; mean age 54 years). Age, gender, associated injuries, fracture type, Injury Severity Score rating and treatment methods were assessed, and Majeed score for functional outcome and radiographic studies at 1 year after injury (short-term) and at final follow-up (long-term), with mean follow-up of 98 months were analyzed...
January 2017: Journal of Orthopaedic Surgery
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