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Karl S Benz, Emily Dunn, Mahir Maruf, James Facciola, John Jayman, Matthew Kasprenski, Jason E Michaud, Heather Di Carlo, John P Gearhart
PURPOSE: To use Magnetic Resonance Imaging to define the innate pelvic neurovascular course and prostate anatomy in infants with classic bladder exstrophy before their pelvis is altered by surgery. MATERIALS AND METHODS: Pelvic Magnetic Resonance Imaging was performed on male classic bladder exstrophy infants and compared to a group of age matched controls. Data collected included the prostatic dimensions as well as the course of the prostatic artery, periprostatic vessels, and pudendal neurovasculature...
June 12, 2018: Journal of Urology
Min Cheol Chang
BACKGROUND: Recently, clinicians have been applying pulsed radiofrequency (PRF) stimulation on various peripheral nerves to manage patients' peripheral neuropathic pain. OBJECTIVES: To review the literature on the use and efficacy of PRF for controlling peripheral neuropathic pain. STUDY DESIGN: This is a narrative review of relevant articles on the effectiveness of PRF for peripheral neuropathic pain. METHODS: A PubMed search was conducted for papers published from January 1, 1980 to August 31, 2017 that used PRF to treat peripheral neuropathic pain...
May 2018: Pain Physician
Sang Min Lee, Ji Hoon Shin, Jong Joon Shim, Ki Woong Yoon, Young Jong Cho, Jong Woo Kim, Heung Kyu Ko
OBJECTIVES: To evaluate the safety and efficacy of transcatheter arterial embolisation (TAE) managing postpartum haemorrhage associated with genital tract injury (PPH-GTI) and to determine the factors associated with clinical outcomes. METHODS: From 2002 to 2017, a retrospective analysis was performed in 60 patients (mean 31.5 years) undergoing TAE for PPH-GTI. Information regarding clinical data, angiography and embolisation details, and clinical outcomes was obtained...
May 28, 2018: European Radiology
Jacques Beco, Laurence Seidel, Adelin Albert
BACKGROUND: Pudendal nerve entrapment can produce a pudendal syndrome comprising perineodynia together with urinary, sexual, and anorectal symptoms. This syndrome can be treated surgically by the transperineal approach. By using an endoscope during the procedure ("operative pudendoscopy"), the surgeon has close-up visual control of each decompression steps, demonstrates the different levels of entrapment, and cuts the sacrospinous ligament under visual control. The aim of this study was to describe the technical details of this new technique and its outcome in the treatment of the pudendal syndrome...
May 23, 2018: Surgical Endoscopy
Douglas A Canning
No abstract text is available yet for this article.
June 2018: Journal of Urology
Alexander Andreev-Andrievskiy, Evgeniia Lagereva, Anfisa Popova
BACKGROUND: Penile erection is a complex reflex under spinal control and modulated by the brain. The hemodynamic events under autonomic control and the perineal muscles somatic activity are interconnected during the reflex erection at the spinal level, however if the afferent feedback on the corpus cavernosum pressure during an erection affects the somatic activity (perineal muscles contractions) and vice versa is not known. This study was aimed to test this hypothesis using a rat model...
May 8, 2018: BMC Urology
P Meignan, A Binet, A R Cook, H Lardy, G Captier
PURPOSE: The median sacral artery (MSA) is the termination of the dorsal aorta, which undergoes a complex regression and remodeling process during embryo and fetal development. The MSA contributes to the pelvic vascularization and may be injured during pelvic surgery. The embryological steps of MSA development, anastomosis formation and anatomical variations are linked, but not fully understood. METHODS: The pelvic vascularization and more precisely the MSA of a human fetus at 22 weeks of gestation (GW) were studied using micro-CT imaging...
July 2018: Surgical and Radiologic Anatomy: SRA
Parthena I Deskoulidi, Pantelis K Diamantopoulos, Nikolaos A Maltzaris, Maria D Kotrotsiou, Konstantinos M Benetatos, Spiros D Stavrianos
Reconstruction of perineal defects is a challenging procedure. Various surgical techniques have been proposed. Compared with traditional myocutaneous flaps, pedicled perforator flaps are believed to be a less invasive option for perineal reconstruction, with better functional and cosmetic results. We present the case of a 47-year-old woman with a perianal Paget's disease who underwent surgical excision of the lesion. The reconstructive technique was a pedicled flap based on an internal pudendal skin perforator artery...
March 2018: Plastic and Reconstructive Surgery. Global Open
Ahmet Kale, Gulfem Basol, Taner Usta, Isa Cam
STUDY OBJECTIVE: To demonstrate the laparoscopic approach to malformed branches of the vessels entrapping the nerves of the sacral plexus. DESIGN: A step-by-step explanation of the surgery using video (educative video) (Canadian Task force classification II). The university's Ethics Committee ruled that approval was not required for this video. SETTING: Kocaeli Derince Education and Research Hospital, Kocaeli, Turkey. PATIENT: A 26-year-old patient who had failed medical therapy and presented with complaints of numbness and burning pain on the right side of her vagina and pain radiating to her lower limbs for a period of approximately 36 months...
April 24, 2018: Journal of Minimally Invasive Gynecology
D G Chakhunashvili, N Lomidze, L Karalashvili, L Kikalishvili, K Chakhunashvili, Z Kakabadze
Management of congenital abdominal wall malformations is still a challenge in paediatric surgery due to visceroabdominal disproportion, large defects of abdominal wall and immature abdominal cavity. Most of the patients treated with primary closure need artificial substitutes like patches or biomaterials for non-permanent abdominal wall closure. Patches represent the source of constant infections and complications like separation of prosthesis from fascia. Removal of these patches and ventral hernia repair is essential afterwards...
March 2018: Georgian Medical News
R Mercut, R Sinna, R Vaucher, P A Giroux, N Assaf, A Lari, S Dast
OBJECTIVE: Perineal defects are encountered ever more frequently, in the treatment of vulvar cancers or abdominoperineal resection. The surgical treatment of vulvar cancer leads to significant skin defect. The aim of the reconstruction is not to provide volume but rather to resurface perineum. We propose a new solution to cover the extensive skin defect remaining after excision. METHODS: We report 3 patients who underwent large excision for vulvar cancer, with lymph node dissection...
April 9, 2018: Annales de Chirurgie Plastique et Esthétique
James F X Jones
The pudendal nerves can be injured during traumatic vaginal childbirth and result in faecal incontinence. Some of these incontinent patients benefit from chronic sacral neuromodulation and the mechanism of action of this therapy has been a focus of many studies. In 2008, a rodent model of neuropathic faecal incontinence was introduced and subsequently validated through a series of investigations. This review summarizes the decade-long contribution of Professor Ronan O'Connell to the inception and application of this rodent model of faecal incontinence and sacral neuromodulation...
April 8, 2018: Irish Journal of Medical Science
Ke-Vin Chang, Wei-Ting Wu, Levent Özçakar, Carlo Martinoli
No abstract text is available yet for this article.
March 30, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Gregory L Cvetanovich, Bryan M Saltzman, Gift Ukwuani, Rachel M Frank, Nikhil N Verma, Charles A Bush-Joseph, Shane J Nho
PURPOSE: To define the anatomy of the pudendal nerve in relationship to the proximal hamstring and other nearby neurological structures during proximal hamstring repair. METHODS: Six fresh-frozen human cadaveric hemi-pelvises from male patients ages 64.0 ± 4.1 years were dissected in prone position with hips in 10° flexion to identify the relationship of proximal hamstring origin to surrounding neurologic structures including the pudendal nerve, sciatic nerve, and posterior femoral cutaneous nerve...
March 29, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Claire C Yang, Jane L Miller, Adam Omidpanah, John N Krieger
OBJECTIVE: To examine the feasibility of implementing a standardized, clinically relevant genitourinary examination for both men and women, and to identify physical examination findings characteristic of urologic chronic pelvic pain syndrome (UCPPS). MATERIALS AND METHODS: This study analyzed 2 samples: men and women with UCPPS who participated in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network Epidemiology and Phenotyping (EP) Study, and age-matched controls who were either positive for chronic fatigue syndrome or healthy (pain-free)...
June 2018: Urology
Harumi Hotta, Harue Suzuki, Kaori Iimura, Nobuhiro Watanabe
The brainstem is essential for producing micturition contractions of the urinary bladder. Afferent input from perineal skin evoked by gentle mechanical stimulation inhibits micturition contractions by decreasing both ascending and descending transmissions between the brainstem and spinal cord. Dysfunction of this inhibitory mechanism may be one cause of the increase in the prevalence of overactive bladder in old age. The aim of this study was to examine effect of aging on function of skin afferent fibers that inhibit bladder micturition contractions in rats...
2018: Frontiers in Neuroscience
E Chantalat, C Vaysse, M C Delchier, B Bordier, X Game, P Chaynes, E Cavaignac, M Roumiguié
OBJECTIVE: In radical cystectomy, the surgeon generally ligates the umbilical artery at its origin. This artery may give rise to several arteries that supply the sexual organs. Our aim was to evaluate pelvic and perineal devascularisation in women after total cystectomy. PATIENTS AND METHODS: We carried out a prospective anatomical and radiological study. We performed bilateral pelvic dissections of fresh adult female cadavers to identify the dividing branches of the umbilical artery...
March 27, 2018: Surgical and Radiologic Anatomy: SRA
Stanley J Antolak, Christopher M Antolak
BACKGROUND: Chronic pelvic pain (CPP) in men is rarely considered to have a neurogenic (neuropathic) basis. Separation of neurogenic from non-neurogenic pain is possible using clinical examination and neurophysiologic tests. A definite diagnosis of neuropathic pain can be made. OBJECTIVES: We aim to demonstrate that definite pudendal neuropathic abnormalities can be supported by a quantitative sensory test (QST) called the warm temperature threshold detection (WDT) test in men with CPP...
March 2018: Pain Physician
Joanie Mercier, An Tang, Mélanie Morin, Marie-Claude Lemieux, Samir Khalifé, Barbara Reichetzer, Chantale Dumoulin
INTRODUCTION AND HYPOTHESIS: The internal pudendal artery (IPA) is one of the main arteries supplying the pelvic floor muscles (PFMs) and vulvo-vaginal tissues. Its assessment with color Doppler ultrasound has been documented previously, but the reliability of IPA measurements has never been assessed. This study evaluates the test-retest reliability of IPA blood flow parameters measured by color Doppler ultrasound under two conditions: at rest and after a PFM contraction task. METHODS: Twenty healthy women participated in this study...
March 19, 2018: International Urogynecology Journal
Wataru Jomoto, Masao Tanooka, Hiroshi Doi, Keisuke Kikuchi, Chiemi Mitsuie, Yusuke Yamada, Toru Suzuki, Toshiko Yamano, Reiichi Ishikura, Noriko Kotoura, Shingo Yamamoto
We sought to develop a surgical navigation system using magnetic resonance angiography (MRA) and a three-dimensional (3D) printer for robot-assisted radical prostatectomy (RARP). Six patients with pathologically proven localized prostate cancer were prospectively enrolled in this study. Prostate magnetic resonance imaging (MRI), consisting of T2-weighted sampling perfection with application-optimized contrasts using different flip-angle evolutions (SPACE) and true fast imaging with steady-state precession (true FISP), reconstructed by volume rendering, was followed by dynamic contrast-enhanced MRA performed with a volumetric interpolated breath-hold examination (VIBE) during intravenous bolus injection of gadobutrol...
January 2, 2018: Curēus
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