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https://www.readbyqxmd.com/read/29042697/vaginoplasty-with-a-pudendal-groin-flap-in-male-to-female-transsexuals
#1
Yuko Mukai, Toshiyuki Watanabe, Morito Sugimoto, Yoshihiro Kimata, Yuzaburo Namba
Many vaginoplasty techniques have been introduced to improve the outcomes of sex reassignment surgery for male-to-female transsexuals. Some vaginoplasty patients still require additional skin grafts, making dilation mandatory to overcome shrinkage. We developed a new vaginoplasty method (called the "pudendal-groin flap") that uses pudendal-groin flaps. One of this procedure's advantages is that skin grafts are unnecessary, even for patients with small penises and scrotums. We introduce the procedure here and describe our evaluation of its utility...
October 2017: Acta Medica Okayama
https://www.readbyqxmd.com/read/29034542/time-frequency-analysis-of-increases-in-vaginal-blood-perfusion-elicited-by-long-duration-pudendal-neuromodulation-in-anesthetized-rats
#2
Indie C Rice, Lauren L Zimmerman, Shani E Ross, Mitchell B Berger, Tim M Bruns
OBJECTIVES: Female sexual dysfunction (FSD) affects a significant portion of the population. Although treatment options for FSD are limited, neuromodulation for bladder dysfunction has improved sexual function in some women. A few studies have investigated peripheral neuromodulation for eliciting changes in vaginal blood flow, as a proxy for modulating genital sexual arousal, however results are generally transient. Our central hypothesis is that repeated or extended-duration pudendal nerve stimulation can elicit maintained vaginal blood flow increases...
October 16, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29016507/cadaveric-nerve-and-artery-proximity-to-sacrospinous-ligament-fixation-sutures-placed-by-a-suture-capturing-device
#3
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...
October 6, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28988909/detailed-muscular-structure-and-neural-control-anatomy-of-the-levator-ani-muscle-a-study-based-on-female-human-fetuses
#4
Krystel Nyangoh Timoh, David Moszkowicz, Mazen Zaitouna, Cedric Lebacle, Jelena Martinovic, Djibril Diallo, Maud Creze, Vincent Lavoue, Emile Darai, Gérard Benoit, Thomas Bessede
BACKGROUND: Injury to the levator ani muscle or pelvic nerves during pregnancy and vaginal delivery are responsible for pelvic floor dysfunction. OBJECTIVE: To demonstrate the presence of smooth muscular cell areas within the levator ani muscle and describe their localization and innervation. STUDY DESIGN: Five female human fetuses were studied after approval from the French Biomedicine Agency. Specimens were serially sectioned and stained by Masson's trichrome and immunostained for striated and smooth muscle, as well as for somatic, adrenergic, cholinergic, and nitriergic nerve fibers...
October 5, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28965315/surgical-techniques-for-managing-post-prostatectomy-erectile-dysfunction
#5
REVIEW
Fabio Castiglione, David J Ralph, Asif Muneer
PURPOSE OF REVIEW: Due to the increasing numbers of radical prostatectomies (RP) performed for prostate cancer, a substantial number of patients are now suffering from post-operative erectile dysfunction (ED). The aim of this study is to summarize the current literature on surgical techniques for managing post-prostatectomy erectile dysfunction. RECENT FINDINGS: The PubMed database was searched for English-language articles published up to Jan 2017 using the following search terms: "prostatectomy AND erectile dysfunction", "prostatectomy AND penile prostheses", and "prostatectomy AND penile implants"...
September 30, 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28952694/-transperineal-ultrasound-imaging-of-the-internal-pudendal-artery-in-arteriogenic-erectile-dysfunction
#6
E Povelitsa, N I Dosta, O V Parhomenko, D M Nitkin, A M Shesternja, V V Anichkin
AIM: To determine the practical and diagnostic value of transperineal ultrasound imaging of the internal pudendal artery (IPA) in patients with arteriogenic erectile dysfunction (ED). MATERIALS AND METHODS: Transperineal IPA and penile Doppler ultrasonography was performed in 50 healthy young male volunteers aged 23.6+/-3.4 years without ED (IIEF-5 score of 21-22) and 60 patients with ED (IIEF-5 score of 6-18, mean age 49+/-4.6 years), including 30 men with prostate cancer (PCa) after comprehensive treatment and 30 patients with type 1 and type 2 diabetes mellitus...
September 2017: Urologii︠a︡
https://www.readbyqxmd.com/read/28941806/contemporary-review-of-male-and-female-climacturia-and-urinary-leakage-during-sexual-activities
#7
REVIEW
Melissa H Mendez, Stephanie J Sexton, Aaron C Lentz
INTRODUCTION: Urinary leakage during sexual activity is a prevalent and often distressing condition that is under-addressed despite having a range of reasonable treatment options. AIM: To review the available literature on prevalence, pathophysiology, and treatment of urinary leakage during sexual activities. METHODS: A literature review was performed through PubMed from 1996 to 2017 regarding urinary leakage during sexual activities for men and women including foreplay incontinence, coital incontinence, and climacturia...
September 20, 2017: Sexual Medicine Reviews
https://www.readbyqxmd.com/read/28934788/repeated-ganglion-impar-block-in-a-cohort-of-83-patients-with-chronic-pelvic-and-perineal-pain
#8
Quentin-Come Le Clerc, Thibault Riant, Amelie Levesque, Jean-Jacques Labat, Stephane Ploteau, Roger Robert, Marie-Aimee Perrouin-Verbe, Jerome Rigaud
BACKGROUND: The ganglion impar is the first pelvic ganglion of the efferent sympathetic trunk that relays pelvic and perineal nociceptive messages and therefore constitutes a therapeutic target. OBJECTIVE: The objective of this single-center study was to evaluate the effectiveness of 3 repeated ganglion impar blocks in patients with chronic pelvic and perineal pain on intention-to-treat. STUDY DESIGN: Retrospective single-center study. SETTING: We reviewed the medical records of 83 patients with chronic refractory pelvic and perineal pain...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28931549/sacral-neuromodulation-blocks-pudendal-inhibition-of-reflex-bladder-activity-in-cats-insight-into-the-efficacy-of-sacral-neuromodulation-in-fowler-s-syndrome
#9
Xing Li, Jamie Uy, Michelle Yu, Shun Li, Katherine Theisen, Jeffrey Browning, Bing Shen, Jicheng Wang, James R Roppolo, William C de Groat, Changfeng Tai
This study tested the hypothesis that sacral neuromodulation, i.e. electrical stimulation of afferent axons in sacral spinal root, can block pudendal afferent inhibition of the micturition reflex. In α-chloralose anesthetized cats, pudendal nerve stimulation (PNS) at 3-5 Hz was used to inhibit bladder reflex activity while the sacral S1 or S2 dorsal root was stimulated at 15-30 Hz to mimic sacral neuromodulation and to block the bladder inhibition induced by PNS. The intensity threshold (T) for PNS or S1/S2 dorsal root stimulation (DRS) to induce muscle twitch of anal sphincter or toe was determined...
September 20, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/28922462/vaginal-mesh-repair-systems-for-pelvic-organ-prolapse-anatomical-study-comparing-transobturator-trangluteal-versus-single-incision-techniques
#10
Giuseppe Campagna, Giovanni Panico, Andrea Morciano, Pierre Gadonneix, Vincent Delmas, Mauro Cervigni, Alfredo Ercoli, Giovanni Scambia
INTRODUCTION: The present study aim to compare the anatomic landmarks of two pelvic floor repair systems, in order to identify the potential neurovascular lesions related to different mesh fixation techniques. METHODS: Abdominal and perineal dissections of 10 fresh cadavers after prolapse surgery using transobturator/transgluteal versus single incision techniques. Neuro-vascular structures of obturator region and perineum were isolated. Distances between needles and anatomical structures were measured...
September 18, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28901946/design-of-semg-assembly-to-detect-external-anal-sphincter-activity-a-proof-of-concept
#11
Arsam Shiraz, Brian Leaker, Charles Alexander Mosse, Eskinder Solomon, Michael Craggs, Andreas Demosthenous
Conditional trans-rectal stimulation of the pudendal nerve could provide a viable solution to treat hyperreflexive bladder in spinal cord injury. A set threshold of the amplitude estimate of the external anal sphincter surface electromyography (sEMG) may be used as the trigger signal. The efficacy of such a device should be tested in a large scale clinical trial. As such a probe should remain in situ for several hours while patients attend to their daily routine, the recording electrodes should be designed to be large enough to maintain good contact while observing design constraints...
September 13, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28900705/clinical-relevance-of-neurological-evaluation-in-patients-suffering-urinary-retention-in-the-absence-of-subvesical-obstruction
#12
N Schwertner-Tiepelmann, A Hagedorn-Wiesner, C Erschig, K Beilecke, F Schwab, R Tunn
PURPOSE: Clinical relevance of neurological evaluation in patients suffered urinary retention in the absence of subvesical obstruction. Determining whether (1) women complaining residual bladder volume without prolapse and obstruction always suffer pudendal nerve damage; (2) neurogenic damage can be linked to patients history/clinical examination; (3) therapy alters regarding to neurological findings; and (4) electromyography (EMG) of musculus sphincter ani externus (MSAE) can be omitted with electronically stimulated pudendal nerve latency (ESPL) as the standard investigation...
September 12, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28884835/non-invasive-electromyographic-estimation-of-motor-unit-number-in-the-external-anal-sphincter-of-the-rat
#13
Chuan Zhang, Alvaro Munoz, H Henry Lai, Timothy Boone, Yingchun Zhang
AIMS: The external anal sphincter (EAS) is essential for maintaining fecal continence. Neurological disorders or traumatic injuries to muscle and nervous systems could lead to EAS denervation. Currently, there are no techniques available to document global innervation changes in the EAS in vivo. The aim of this study was to develop a novel approach to non-invasively estimate the number of functioning motor units (MUs) in the EAS and validate with immunofluorescent techniques in rats. METHODS: Intra-rectal surface electromyography (EMG) signals of the EAS, induced by a series of intra-vaginally delivered pudendal nerve stimulations with different intensities, were recorded...
September 8, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28883698/hypothesized-summative-anal-physiology-score-correlates-but-poorly-predicts-incontinence-severity
#14
Christopher J Young, Assad Zahid, Cherry E Koh, Jane M Young
AIM: To explore the relationship between such a construct and an existing continence score. METHODS: A retrospective study of incontinent patients who underwent anal physiology (AP) was performed. AP results and Cleveland Clinic Continence Scores (CCCS) were extracted. An anal physiology score (APS) was developed using maximum resting pressures (MRP), anal canal length (ACL), internal and external sphincter defects and pudendal terminal motor latency. Univariate associations between each variable, APS and CCCS were assessed...
August 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28859491/analysis-of-accessory-pudendal-artery-transection-on-erections-during-robot-assisted-radical-prostatectomy
#15
Stephen B Williams, Blanca E Morales, Linda M Huynh, Kathryn Osann, Douglas W Skarecky, Thomas E Ahlering
PURPOSE: To compare the recovery of erections and potency following the transection of accessory pudendal arteries (APAs) in men undergoing robot-assisted radical prostatectomy (RARP) compared with men with normal vascular anatomy. MATERIALS AND METHODS: A total of 880 consecutive patients who underwent RARP from January 1, 2007 to December 31, 2014 were included with prospectively collected data in cross-sectional analysis. Erectile function (EF) was assessed preoperatively and postoperatively at 3, 6, 12, and 24 months using the International Index of Erectile Function (IIEF)-5, a percent erection fullness compared to preoperative status, and two Expanded Prostate Cancer Index (EPIC) questions: (1) are erections firm enough for penetration and (2) are they satisfactory? RESULTS: Two hundred thirty-one (33...
October 4, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28801220/multiple-reflex-pathways-contribute-to-bladder-activation-by-intraurethral-stimulation-in-persons-with-spinal-cord-injury
#16
Meredith J McGee, Brandon D Swan, Zachary C Danziger, Cindy L Amundsen, Warren M Grill
OBJECTIVE: To measure the urodynamic effects of electrical co-stimulation of 2 individual sites in the proximal and distal urethra in persons with spinal cord injury (SCI). This work was motivated by preclinical findings that selective co-stimulation of the cranial urethral sensory nerve and the dorsal genital nerve, which innervate the proximal and distal portions of the urethra, respectively, increased reflex bladder activation and voiding efficiency. MATERIALS AND METHODS: Electrical co-stimulation of urethral afferents was conducted in persons with chronic SCI during urodynamics...
August 8, 2017: Urology
https://www.readbyqxmd.com/read/28796733/outcomes-of-immediate-internal-pudendal-artery-perforator-flap-reconstruction-for-irradiated-abdominoperineal-resection-defects
#17
Pedro S Coltro, Fábio F Busnardo, Franklin C Mônaco Filho, Marcelo V Olivan, Lincoln S Millan, Victor A Grillo, Carlos F Marques, Caio S Nahas, Sérgio C Nahas, Ulysses Ribeiro, Rolf Gemperli
BACKGROUND: There are many previous reports for using the internal pudendal artery perforator flap in vulvovaginal reconstruction; however, reports of this flap for perineal reconstruction after abdominoperineal excision of the rectum are scarce. OBJECTIVE: The purpose of this study was to evaluate the outcomes of immediate internal pudendal artery perforator flap reconstruction for irradiated abdominoperineal resection defects. DESIGN: This was a prospective case series...
September 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28767166/radiological-anatomy-of-the-perforators-of-the-gluteal-region-the-radiosome-based-anatomy
#18
Enrico Vigato, Eleonora De Antoni, Cesare Tiengo, Andrea Porzionato, Cinzia Tortorella, Maurizio Governa, Veronica Macchi, Raffaele De Caro
BACKGROUND: The superior (SGA) and the inferior gluteal artery (IGA) perforator flaps are widely used in pressure-sore repair and in breast reconstruction. The aim was to exhaustively depict the topographical anatomy of the whole system of perforators in the buttock. METHODS: Eighty lower-extremity computed tomographic angiography (CTA) of patients (20 males/20 females, mean age 61-years old, range 38-81) were considered. The source artery, location, type, and caliber of gluteal perforators were analyzed...
August 2, 2017: Microsurgery
https://www.readbyqxmd.com/read/28749171/prospective-evaluation-of-a-specific-technique-of-sexual-function-preservation-in-external-beam-radiotherapy-for-prostate-cancer
#19
Hamza Samlali, Corina Udrescu, Ariane Lapierre, Ciprian Enachescu, Alain Ruffion, Patrice Jalade, Olivier Chapet
OBJECTIVE: Sexual preservation is an important issue in the treatment of localized prostate cancer. A technique of irradiation was developed to better preserve this function and has been evaluated. METHODS: Eleven patients, with no erectile dysfunction (ED), were treated with daily IMRT-IGRT (total dose: 76-78 Gy). The pudendal arteries, penile bulb and cavernous body were delineated on the planning CT scan. The doses to these structures (with a 5 mm margin) were optimized to be as low as possible...
October 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28726248/finding-sacral-developmental-evolution-of-the-axial-skeleton-of-odontocetes-cetacea
#20
Emily A Buchholtz, Jessica K Gee
Axial morphology was dramatically transformed during the transition from terrestrial to aquatic environments by archaeocete cetaceans, and again during the subsequent odontocete radiation. Here, we reconstruct the sequence of developmental events that underlie these phenotypic transitions. Archaeocete innovations include the loss of primaxial/abaxial interaction at the sacral/pelvic articulation and the modular dissociation of the fluke from the remainder of the tail. Odontocetes subsequently integrated lumbar, sacral, and anterior caudal vertebrae into a single torso module, and underwent multiple series-specific changes in vertebral count...
July 2017: Evolution & Development
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