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Pelvic nerve damage

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
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
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
J R Petrasic, A Chhabra, K M Scott
BACKGROUND AND PURPOSE: Chronic cauda equina syndrome, defined as persistent damage of the cauda equina nerve roots within the spinal canal can be a challenging diagnosis with varied presentations. MR neurography imaging is more commonly being used to evaluate the lumbosacral spine of patients suspected of having subacute or chronic cauda equina syndrome. Our aim was to evaluate the impact of lumbosacral plexus MR neurography in the diagnostic thinking and therapeutic management of patients presenting with chronic pelvic pain and dysfunction and suspected chronic cauda equina syndrome...
November 10, 2016: AJNR. American Journal of Neuroradiology
Weidong Tong, Yue Tian, Hanyong Yang, Li Wang, Song Zhao, Huiwen Shi, Feixiang Dai, Jingwang Ye
BACKGROUND: It has been reported that colorectal motility dysfunction due to pelvic nerve (PN) damage is restored overtime. However, the adaptive mechanism is unknown. Previous studies implied that transient receptor potential ankyrin 1 (TRPA1) mediated sensory nerve signal input plays a crucial role in gut motility regulation. The present study aimed to observe the colorectal motility restoration in rats after PN transection and to explore the change of TRPA1 protein expression in this adaptive process...
October 4, 2016: Journal of Surgical Research
En Jen, Tsung-Hsun Hsieh, Tsung-Che Lu, Meng-Chao Chen, Fu-Jung Lee, Chih-Ting Lin, Shih-Ching Chen, Pei-Yi Chu, Chih-Wei Peng, Chii-Wann Lin
AIM: To quantify the effects of pulsed radiofrequency (PRF) electrical stimulations of the pudendal and pelvic nerves on the bladder function of rats with detrusor overactivity. METHODS: All rats were pretreated with a continuous transvesical infusion of 0.5% acetic acid (AA) for inducing detrusor overactivity. Intravesical pressure was recorded using cysometrography (CMG) during the continuous transvesical infusion to examine the effects of PRF electrical stimulation of the pudendal and pelvic nerves individually...
November 28, 2016: Neurourology and Urodynamics
Noeska Smit, Kai Lawonn, Annelot Kraima, Marco DeRuiter, Hessam Sokooti, Stefan Bruckner, Elmar Eisemann, Anna Vilanova
Due to the intricate relationship between the pelvic organs and vital structures, such as vessels and nerves, pelvic anatomy is often considered to be complex to comprehend. In oncological pelvic surgery, a trade-off has to be made between complete tumor resection and preserving function by preventing damage to the nerves. Damage to the autonomic nerves causes undesirable post-operative side-effects such as fecal and urinal incontinence, as well as sexual dysfunction in up to 80 percent of the cases. Since these autonomic nerves are not visible in pre-operative MRI scans or during surgery, avoiding nerve damage during such a surgical procedure becomes challenging...
January 2017: IEEE Transactions on Visualization and Computer Graphics
Rainer Kimmig, Peter Rusch, Paul Buderath, Bahriye Aktas
Superior hypogastric plexus (SHG) contains mainly sympathetic and most probably also postganglionic parasympathetic fibers. Thus, surgical damage of SHG may cause autonomic pelvic organ dysfunction (Kraima et al., 2015). As already shown for rectal cancer, preservation of the autonomic nerves is facilitated by robotic surgery and may avoid sexual dysfunctions and voiding disorders (Kim et al., 2015). In this educational video, we demonstrate left lower paraaortic lymph node dissection preserving the SHG using ICG fluorescence to label the lymphatic compartment...
November 2016: Gynecologic Oncology Reports
Artur Oberc, Jerzy Sułko
The aim of the paper is to present the case of a 3-year-old boy with an unaligned fracture of the sacroiliac joint region to propose a minimally invasive method of fracture fixation without using metal implants and to review the literature addressing this injury, which is uncommon in children. The patient was hit by a car; he suffered a fracture of the iliac ala with a complete traumatic damage to the L4-L5 nerve roots. The fracture was fixated by osteosuture and normal bone fusion was achieved. The follow-up period was 4 years...
September 8, 2016: Journal of Pediatric Orthopedics. Part B
V Džupa, J Němec, Z Pavlíčko, M Laboš, J Šrám, S Taller, V Báča
UNLABELLED: PURPOSE OF THE STUDY This radiographic study was focused on measuring the dimensions of pelvic bones at sites of minimally invasive screw insertion with the aim to assess the risk of damage to vascular and nervous structures. MATERIAL AND METHODS The group consisted of 77 patients (39 women and 38 men) aged between 19 and 85 years (average, 65; women, 65; men, 64) who underwent CT examination of the pelvis because of reasons other than injury. On the left side, a total of 14 dimensions of the superior pubic ramus, supraacetabular region, retroacetabular region, quadrilateral surface of the acetabulum and lateral foraminal sides of the S1 and S2 vertebral bodies were measured...
2016: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Audrius Dulskas, Povilas Miliauskas, Renatas Tikuisis, Ricardo Escalante, Narimantas E Samalavicius
Introduction For more than the last 20 years, low anterior resection with total mesorectal excision (TME) is a gold standard for rectal cancer treatment. Oncological outcomes have improved significantly and now more and more reports of functional outcomes appear. Due to the close relationship between the rectum and pelvic nerves, bowel, bladder, and sexual function are frequently affected during TME. Methods A search for published data was performed using the MEDLINE database (from 1 January 2005 to 31 January 2015) to perform a systematic review of the studies that described anorectal, bladder, and sexual dysfunction following rectal cancer surgery...
February 2016: Acta Chirurgica Belgica
Maria E Florian-Rodriguez, Adam Hare, Kathryn Chin, John N Phelan, Christopher M Ripperda, Marlene M Corton
BACKGROUND: Reported rates of gluteal pain after sacrospinous ligament fixation range from 12-55% in the immediate postoperative period and from 4-15% 4-6 weeks postoperatively. The source of gluteal pain often is attributed to injury to the nerve to levator ani or pudendal nerve. The inferior gluteal nerve and other sacral nerve branches have not been examined thoroughly as potential sources of gluteal pain. OBJECTIVES: The purpose of this study was to further characterize anatomy of the inferior gluteal nerve and other nerves that are associated with the sacrospinous ligament from a combined gluteal and pelvic approach and to correlate findings to sacrospinous ligament fixation...
November 2016: American Journal of Obstetrics and Gynecology
M Choudhary, F Clavica, R van Mastrigt, E van Asselt
Electrophysiological studies of whole organ systems in vitro often require measurement of nerve activity and/or stimulation of the organ via the associated nerves. Currently two-compartment setups are used for such studies. These setups are complicated and require two fluids in two separate compartments and stretching the nerve across one chamber to the other, which may damage the nerves. We aimed at developing a simple single compartment setup by testing the electrophysiological properties of FC-770 (a perfluorocarbon) for in vitro recording of bladder afferent nerve activity and electrical stimulation of the bladder...
June 20, 2016: Physiological Research
Ping-Chia Li, Li-Fen Liu, Ming-Jia Jou, Hao-Kuang Wang
BACKGROUND: Glucagon-like peptide 1 (GLP-1) analogs protect a variety of cell types against oxidative damage and vascular and neuronal injury via binding to GLP-1 receptors. This study aimed to investigate the effects of the GLP-1 analogs exendin-4 and liraglutide on cerebral blood flow, reactive oxygen species production, expression of oxidative stress-related proteins, cognition, and pelvic sympathetic nerve-mediated bladder contraction after middle cerebral artery occlusion (MCAO) injury in the db/db mouse model of diabetes...
2016: BMC Neuroscience
Lisa Rogo-Gupta, Mario Castellanos
PURPOSE OF REVIEW: Since 2011, there has been increasing attention paid to the use of synthetic grafts (mesh) in pelvic reconstructive surgery. Although synthetic grafts are considered permanent implants to improve outcomes, the use of this material has created inadvertent complications such as erosion, chronic pain, and dyspareunia. Patient evaluation is complex and surgical techniques carry risks not yet completely understood. This review summarizes current opinions in synthetic graft excision for the treatment of mesh-related complications...
August 2016: Current Opinion in Obstetrics & Gynecology
Gulden Menderes, Nicole Vilardo, Carlton L Schwab, Masoud Azodi
OBJECTIVE: To demonstrate a surgical video wherein left obturator nerve was iatrogenically injured during pelvic lymphadenectomy and repaired immediately with laparoscopic epineural end-to-end tension free anastomosis. METHODS: This is a step-by-step demonstration of an incidental injury and laparoscopic repair of left obturator nerve during pelvic lymphadenectomy. The patient was a 59year-old Hispanic female who was found to have endometrial adenocarcinoma. She was referred to our division for laparoscopic staging during which left obturator nerve was iatrogenically injured...
July 2016: Gynecologic Oncology
Qiao Qiao, Xiangming Che, Xuqi Li, Shicai He, Guanglin Qiu, Jing Lu, Jin Wang, Lin Fan
BACKGROUND: Postoperative urinary dysfunction after total mesorectal excision (TME) is lessened by preservation of the autonomic nerves, but in T4 rectal tumors such injury often cannot be prevented. This retrospective study evaluated the recovery of urinary function of patients with injury to a single pelvic autonomic nerve subsequent to laparoscopic TME, relative to patients without nerve damage. METHODS: Patients with T4 rectal cancer who underwent laparoscopic TME were divided according to the presence of a single pelvic autonomic nerve injury (37 cases) or no injury to autonomic nerves (54 cases; control)...
August 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
M Fermaut, K Nyangoh Timoh, C Lebacle, D Moszkowicz, G Benoit, T Bessede
OBJECTIVES: Deep pelvic endometriosis surgery may need substantial excisions, which in turn expose to risks of injury to the pelvic nerves. To limit functional complications, nerve-sparing surgical techniques have been developed but should be adapted to the specific multifocal character of endometriotic lesions. The objective was to identify the anatomical areas where the pelvic nerves are most at risk of injury during endometriotic excisions. METHODS: The Medline and Embase databases have been searched for available literature using the keywords "hypogastric nerve or hypogastric plexus [Mesh] or autonomic pathway [Mesh], anatomy, endometriosis, surgery [Mesh]"...
May 2016: Gynécologie, Obstétrique & Fertilité
Xiaowen He, Guangquan Li, Ruijiang Zhang, Jindao Wang
OBJECTIVE: To explore the effect of arterial infusion with methylene blue during total mesorectal excision (TME) for better preservation of pelvic autonomic nerve on urination function and sexual function in male patients with rectal cancer. METHODS: A total of 68 male rectal cancer patients from Zhejiang Xiaoxing People's Hospital and 44 male rectal cancer patients from Guangdong Zhongshan Chenxinghai Hospital between June 2013 and June 2015 were prospectively enrolled...
April 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Anne C Kraima, Marloes Derks, Noeska N Smit, Cornelis J H van de Velde, Gemma G Kenter, Marco C DeRuiter
OBJECTIVE: Radical hysterectomy with pelvic lymphadenectomy (RHL) is the preferred treatment for early-stage cervical cancer. Although oncological outcome is good with regard to recurrence and survival rates, it is well known that RHL might result in postoperative bladder impairments due to autonomic nerve disruption. The pelvic autonomic network has been extensively studied, but the anatomy of nerve fibers branching off the inferior hypogastric plexus to innervate the bladder is less known...
June 2016: International Journal of Gynecological Cancer
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