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Pudendal neuropathy

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https://www.readbyqxmd.com/read/28900705/clinical-relevance-of-neurological-evaluation-in-patients-suffering-urinary-retention-in-the-absence-of-subvesical-obstruction
#1
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/28883698/hypothesized-summative-anal-physiology-score-correlates-but-poorly-predicts-incontinence-severity
#2
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/28643681/-magnetic-resonance-neurography-for-the-identification-of-pudendal-neuralgia
#3
Claudia P Cejas, Susana Bordegaray, Nadia I Stefanoff, Cecilia Rollán, Inés T Escobar, Pablo Consigliere Rodríguez
The pudendal nerve entrapment is an entity understudied by diagnosis imaging. Various causes are recognized in relation to difficult labors, rectal, perineal, urological and gynecological surgery, pelvic trauma fracture, bones tumors and compression by tumors or pelvic pseudotumors. Pudendal neuropathy should be clinically suspected, and confirmed by different methods such as electrofisiological testing: evoked potentials, terminal motor latency test and electromyogram, neuronal block and magnetic resonance imaging...
2017: Medicina
https://www.readbyqxmd.com/read/28481856/systematic-review-of-animal-models-used-in-research-of-origins-and-treatments-of-fecal-incontinence
#4
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/28408350/neuroactive-steroid-levels-and-psychiatric-and-andrological-features-in-post-finasteride-patients
#5
MULTICENTER STUDY
Roberto Cosimo Melcangi, Daniele Santi, Roberto Spezzano, Maria Grimoldi, Tommaso Tabacchi, Maria Letizia Fusco, Silvia Diviccaro, Silvia Giatti, Giuseppe Carrà, Donatella Caruso, Manuela Simoni, Guido Cavaletti
Recent reports show that, in patients treated with finasteride for male pattern hair loss, persistent side effects including sexual side effects, depression, anxiety and cognitive complaints may occur. We here explored the psychiatric and andrological features of patients affected by post-finasteride syndrome (PFS) and verified whether the cerebrospinal fluid (CSF) and plasma levels of neuroactive steroids (i.e., important regulators of nervous function) are modified. We found that eight out of sixteen PFS male patients considered suffered from a DSM-IV major depressive disorder (MDD)...
July 2017: Journal of Steroid Biochemistry and Molecular Biology
https://www.readbyqxmd.com/read/28339446/pulsed-radiofrequency-ablation-of-pudendal-nerve-for-treatment-of-a-case-of-refractory-pelvic-pain
#6
Vadim Petrov-Kondratov, Avneesh Chhabra, Stephanie Jones
Pudendal neuralgia (PN) is a result of pudendal nerve entrapment or injury, also called "Alcock syndrome." Pain that develops is often chronic, and at times debilitating. If conservative measures fail, invasive treatment modalities can be considered. The goal of this case report is to add to a small body of literature that a pulsed radiofrequency (PRF) ablation can be effectively used to treat PN and to show that high resolution MR neurography imaging can be used to detect pudendal neuropathy. CASE PRESENTATION: We present a case of a 51-year-old woman with 5 years of worsening right groin and vulva pain...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28319326/altered-defaecatory-behaviour-and-faecal-incontinence-in-a-video-tracked-animal-model-of-pudendal-neuropathy
#7
L A Devane, E Lucking, J Evers, M Buffini, S M Scott, C H Knowles, P R O'Connell, J F X Jones
AIM: The aim was to develop a behavioural animal model of faecal continence and assess the effect of retro-uterine balloon inflation (RBI) injury. RBI in the rat causes pudendal neuropathy, a risk factor for obstetric related faecal incontinence in humans. METHOD: Video-tracking of healthy rats (n = 12) in a cage containing a latrine box was used to monitor their defaecatory behaviour index (DBI) over 2 weeks. The DBI (range 0-1) was devised by dividing the defaecation rate (pellets per hour) outside the latrine by that of the whole cage...
May 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28002867/update-on-ultrasound-guided-interventional-procedures-on-peripheral-nerves
#8
REVIEW
Alberto Tagliafico, Bianca Bignotti, Carlo Martinoli
This article is a practical review update on ultrasound (US)-guided interventional procedures on peripheral nerves. Technical considerations, biopsy techniques, and some examples of injections are described. US is considered a safe imaging guidance for interventional procedures, due to its high spatial resolution and the possibility to image the needle and inject drugs in real time. US-guided injections could be considered a diagnostic and therapeutic option in the most common neuropathy, before or as an alternative to surgery...
November 2016: Seminars in Musculoskeletal Radiology
https://www.readbyqxmd.com/read/27725234/a-novel-electrophysiological-method-in-the-diagnosis-of-pudendal-neuropathy-position-related-changes-in-pudendal-sensory-evoked-potentials
#9
Burcu Örmeci, Egemen Avcı, Çigdem Kaspar, Özlem Eranıl Terim, Tibet Erdoğru, A Emre Öge
OBJECTIVE: To examine the diagnostic value of pudendal somatosensory evoked potentials (SEPs) in pudendal nerve entrapment (PNE) neuropathy by stimulating the 2 sides separately after provocation by a standard sitting position. Routine pudendal SEPs performed in the supine position with bilateral simultaneous stimulation may fail to show the abnormality because the complaints of PNE appear or worsen in the sitting position. METHODS: Forty-nine patients with PNE and 16 controls were included...
January 2017: Urology
https://www.readbyqxmd.com/read/27664277/pudendal-nerve-and-branch-neuropathy-magnetic-resonance-neurography-evaluation
#10
REVIEW
Vibhor Wadhwa, Aws S Hamid, Yogesh Kumar, Kelly M Scott, Avneesh Chhabra
Pudendal neuralgia is being increasingly recognized as a cause of chronic pelvic pain, which may be related to nerve injury or entrapment. Due to its complex anatomy and branching patterns, the pudendal nerve abnormalities are challenging to illustrate. High resolution 3 T magnetic resonance neurography is a promising technique for the evaluation of peripheral neuropathies. In this article, the authors discuss the normal pudendal nerve anatomy and its variations, technical considerations of pudendal nerve imaging, and highlight the normal and abnormal appearances of the pudendal nerve and its branches with illustrative case examples...
June 2017: Acta Radiologica
https://www.readbyqxmd.com/read/27618322/ct-guided-perineural-injections-for-chronic-pelvic-pain
#11
REVIEW
Vibhor Wadhwa, Kelly M Scott, Shai Rozen, Adam J Starr, Avneesh Chhabra
Chronic pelvic pain is a disabling condition that affects a large number of men and women. It may occur after a known inciting event, or it could be idiopathic. A common cause of pelvic pain syndrome is neuropathy of the pelvic nerves, including the femoral and genitofemoral nerves, ilioinguinal and iliohypogastric nerves, pudendal nerve, obturator nerve, lateral and posterior femoral cutaneous nerves, inferior cluneal nerves, inferior rectal nerve, sciatic nerve, superior gluteal nerve, and the spinal nerve roots...
September 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/27284095/combined-site-specific-sacral-neuromodulation-and-pudendal-nerve-release-surgery-in-a-patient-with-interstitial-cystitis-and-persistent-arousal
#12
Georgina Louise Armstrong, Thierry Georges Vancaillie
A variety of neuromodulation approaches have been described for the management of pelvic neuropathies, including interstitial cystitis, pudendal neuralgia and persistent genital arousal disorder. The benefits of a combined sacral and pudendal nerve neuromodulator has yet to be explored for these patients. In this report, we describe the case of a 35-year-old woman with a complex pelvic neuropathy resulting in urinary, sexual and gastro-intestinal dysfunction. She presented with an established diagnosis of interstitial cystitis; however, she also fulfilled diagnostic criteria for pudendal neuralgia and persistent genital arousal disorder...
June 9, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27228517/measuring-the-quality-of-pudendal-nerve-perineural-injections
#13
Stanley Antolak, Christopher Antolak, Lisa Lendway
BACKGROUND: Pudendal neuropathy is a tunnel syndrome characterized by pelvic pain and may include bowel, bladder, or sexual dysfunction or a combination of these. One treatment method, pudendal nerve perineural injections (PNPIs), uses infiltration of bupivacaine and corticosteroid around the nerve to provide symptom relief. Bupivacaine also anesthetizes the skin in the receptive field of the nerve that is injected. Bupivacaine offers rapid pain relief for several hours while corticosteroid provides delayed pain control often lasting 3 to 5 weeks...
May 2016: Pain Physician
https://www.readbyqxmd.com/read/26811947/ultrasound-guided-pulsed-radiofrequency-treatment-of-the-pudendal-nerve-in-chronic-pelvic-pain
#14
D Ozkan, T Akkaya, S Yildiz, A Comert
Chronic pelvic pain is a condition that can be caused by pudendal neuralgia, interstitial cystitis, piriformis syndrome and neuropathy of the ilioinguinal, iliohypogastric and genitofemoral nerves. Based on three case reports this article discusses the clinical effectiveness of pulsed high-frequency radiofrequency (PRF) treatment applied to the pudendal nerve under ultrasound guidance in medicinally treated patients with chronic pelvic pain.
February 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/26606029/pelvic-neuralgias-by-neuro-vascular-entrapment-anatomical-findings-in-a-series-of-97-consecutive-patients-treated-by-laparoscopic-nerve-decompression
#15
Marc Possover, Axel Forman
BACKGROUND: Some patients have pelvic, pudendal, or low lumbar pain radiating into the legs that is worse while sitting but differs from pudendal neuralgia. The purpose of this study was to present a new clinical entity of neuropathic pelvic pain by pelvic neuro-vascular entrapment. OBJECTIVES: To report about the locations of predilection for pelvic neurovascular entrapment. STUDY DESIGN: Prospective cohort pre- and post-intervention. SETTING: University referral unit specializing in advanced gynecological surgery and neuropelveology...
November 2015: Pain Physician
https://www.readbyqxmd.com/read/26544817/pudendal-neuropathy-alone-results-in-urge-incontinence-rather-than-in-complete-fecal-incontinence
#16
COMPARATIVE STUDY
Maxime M van Meegdenburg, Erik Heineman, Paul M A Broens
BACKGROUND: Conscious external anal sphincter contraction is mediated by the pudendal nerve. Pudendal neuropathy is, therefore, believed to result in fecal incontinence. Until urge sensation is experienced, fecal continence is maintained by unconscious external anal sphincter contraction, which is regulated by the anal-external sphincter continence reflex. The innervation of unconscious contraction is yet unknown. OBJECTIVE: We aimed to determine whether unconscious contraction is mediated by the pudendal nerve and whether age influences unconscious contraction...
December 2015: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/26070708/anatomic-variations-of-pudendal-nerve-within-pelvis-and-pudendal-canal-clinical-applications
#17
Pedro A Maldonado, Kathleen Chin, Alyson A Garcia, Marlene M Corton
OBJECTIVE: The objective of the study was to examine the anatomic variation of the pudendal nerve in the pelvis, on the dorsal surface of the sacrospinous ligament, and in the pudendal canal. STUDY DESIGN: Detailed dissections of the pudendal nerve were performed in unembalmed female cadavers. Pelvic measurements included the distance from the origin of the pudendal nerve to the tip of ischial spine and the nerve width at its origin. The length of the pudendal canal was measured...
November 2015: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/26033463/the-effect-of-traction-force-and-hip-abduction-angle-on-pudendal-nerve-compression-in-hip-arthroscopy-a-cadaveric-model
#18
Hakan Kocaoğlu, Kerem Başarır, Ramazan Akmeşe, Yasemin Kaya, Muzaffer Sindel, Nurettin Oğuz, Mehmet S Binnet
PURPOSE: To investigate the site of pudendal nerve compression and the relation between traction force and abduction angle regarding pressure levels at setup for hip arthroscopy. METHODS: A total of 17 hips from 9 fresh-frozen cadavers (6 male and 3 female cadavers) were used. The pudendal nerves were dissected, and 3 FlexiForce force sensors (Tekscan, Boston, MA) were implanted on the pudendal nerve where the inferior rectal nerve, perineal nerve, and dorsal nerve of the clitoris/penis emerge...
October 2015: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/25761939/gut-symptoms-in-diabetics-correlate-with-components-of-the-rectoanal-inhibitory-reflex-but-not-with-pudendal-nerve-motor-latencies-or-systemic-autonomic-neuropathy
#19
Kumaran Thiruppathy, Adeel Bajwa, Kean Guan Kuan, Charles Murray, Richard Cohen, Anton Emmanuel
OBJECTIVE: Fecal incontinence (FI) occurs in up to 20% of diabetes mellitus (DM) patients. Rectoanal inhibitory reflex (RAIR) is an enteric anorectal reflex that reflects the integrity of mechanisms in the physiology of FI. We aimed to investigate whether diabetic patients with FI, not constipation, had prolongation of RAIR and altered gut-specific autonomic tone. METHODS: In this prospective case-matched study 31 type I DM (19 FI and 12 constipation) and 42 type II DM (26 FI and 16 constipation)...
June 2015: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/25757510/faecal-incontinence-in-men-referred-for-specialty-care-a-cross-sectional-study
#20
J N Cohan, A B Chou, M G Varma
AIM: Little is known about men with faecal incontinence. We compared clinical findings and quality of life in a large cohort of men and women with faecal incontinence to guide its evaluation and treatment in men. METHOD: We analysed men and women presenting to a tertiary referral centre with faecal incontinence between 2005 and 2013. Demographics, physical examination, anorectal physiology testing, symptom severity (Fecal Incontinence Severity Index) and quality of life (Fecal Incontinence Quality of Life Scale) were recorded...
September 2015: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
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