Home About us Contact
|
Home About us Contact | ||
|
|
||
Pelvic Plexus (pelvic + plexus)
Selected AbstractsIncreased proximal urethral sensory threshold after radical pelvic surgery in women,,NEUROUROLOGY AND URODYNAMICS, Issue 2 2007Thomas M. Kessler Abstract Aim To identify factors that potentially influence urethral sensitivity in women. Patients and Methods The current perception threshold was measured by double ring electrodes in the proximal and distal urethra in 120 women. Univariate analysis using Kaplan,Meier models and multivariate analysis applying Cox regressions were performed to identify factors influencing urethral sensitivity in women. Results In univariate and multivariate analysis, women who had undergone radical pelvic surgery (radical cystectomy n,=,12, radical rectal surgery n,=,4) showed a significantly (log rank test P,<,0.0001) increased proximal urethral sensory threshold compared to those without prior surgery (hazard ratio (HR) 4.17, 95% confidence interval (CI) 2.04,8.51), following vaginal hysterectomy (HR 4.95, 95% CI 2.07,11.85), abdominal hysterectomy (HR 5.96, 95% CI 2.68,13.23), or other non-pelvic surgery (HR 4.86, 95% CI 2.24,10.52). However, distal urethral sensitivity was unaffected by any form of prior surgery. Also other variables assessed, including age, concomitant diseases, urodynamic diagnoses, functional urethral length, and maximum urethral closure pressure at rest had no influence on urethral sensitivity in univariate as well as in multivariate analysis. Conclusions Increased proximal but unaffected distal urethral sensory threshold after radical pelvic surgery in women suggests that the afferent nerve fibers from the proximal urethra mainly pass through the pelvic plexus which is prone to damage during radical pelvic surgery, whereas the afferent innervation of the distal urethra is provided by the pudendal nerve. Better understanding the innervation of the proximal and distal urethra may help to improve surgical procedures, especially nerve sparing techniques. Neurourol. Urodynam. 26:208,212, 2007. © 2006 Wiley-Liss, Inc. [source] Striated Perineal Muscles: Location of Autonomic, Sensory, and Somatic Neurons Projecting to the Male Pig Bulbospongiosus MuscleTHE ANATOMICAL RECORD : ADVANCES IN INTEGRATIVE ANATOMY AND EVOLUTIONARY BIOLOGY, Issue 11 2009Maddalena Botti Abstract The location, number, and size of the neurons innervating the bulbospongiosus muscle (BSM) were studied in male pigs, by means of Fast Blue (FB) retrograde transport. After injection of FB into the left BSM, labeled neurons were found bilaterally in the L2-S4 sympathetic trunk ganglia (STGs), in the caudal mesenteric ganglia (CMGs), in the microganglia of the pelvic plexus (PGs), in a dorsolateral area with respect to the central canal of S1-S3 segments of the spinal cord (SC) and in the S1-S4 ipsilateral and S2-S3 contralateral spinal ganglia (SGs). The mean number of labeled FB cells was 3,122 ± 1,968 in STGs, 979 ± 667 in CMGs, 108 ± 104 in PGs, 89 ± 39 in SC and 77 ± 23 in SGs. The area of the multipolar neurons was 852 ± 22 ,m2 in the STGs, 878 ± 23 ,m2 in the CMGs and 922 ± 31 ,m2 in the PGs. The multipolar SC neurons had an area of 1,057 ± 38 ,m2, while pseudounipolar SG cells had dimensions of 2,281 ± 129 ,m2. Our research enables us to highlight two peculiarities regarding the innervation of the boar BSM: the very high number of labeled autonomic neurons and the particular localization of the motor somatic nucleus. Anat Rec, 2009. © 2009 Wiley-Liss, Inc. [source] Feasibility of autonomic nerve-preserving surgery for advanced rectal cancer based on analysis of micrometastasesBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 11 2005T. Matsumoto Background: Autonomic nerve preservation has been advocated as a means of preserving urinary and sexual function after surgery for rectal cancer, but may compromise tumour clearance. The aim of this study was to determine the incidence of micrometastasis in the connective tissues surrounding the pelvic plexus. Methods: The study included 20 consecutive patients who underwent rectal surgery with bilateral lymph node dissection for advanced cancer. A total of 78 connective tissues medial and lateral to the pelvic plexus and 387 lymph nodes were sampled during surgery. All connective tissue samples and 260 lymph nodes were examined for micrometastases by reverse transcriptase,polymerase chain reaction (RT,PCR) after operation. All patients were followed prospectively for a median of 36·0 months. Results: Of 245 histologically negative lymph nodes, 38 (15·5 per cent) were shown by RT,PCR to harbour micrometastases. However, micrometastases to tissues surrounding the pelvic plexus were detected in only two (3 per cent) of 78 tissues, that is in two of 20 patients. Clinical follow-up showed that the two patients had a poor prognosis owing to distant metastases. Conclusion: Autonomic nerve-preserving surgery may be feasible for advanced rectal cancer, but study of more patients positive for micrometastases is required. Copyright © 2005 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] Development of the human hypogastric nerve sheath with special reference to the topohistology between the nerve sheath and other prevertebral fascial structuresCLINICAL ANATOMY, Issue 6 2008Yusuke Kinugasa Abstract Semi-serial sections from the lumbosacral region of nine fetuses (8,25 weeks gestation) were examined to clarify the lumbar prevertebral fascial arrangement. The prevertebral fasciae became evident after 12 weeks of age. After 20 weeks of age, the hypogastric nerve (HGN) was sandwiched by two fascial structures; the ventral fascia which seemed to correspond to the mesorectal fascia, whereas the dorsal fascia corresponded to the presacral fascia. These fasciae or the HGN sheaths extended laterally along the ventral aspects of the great vessels and associated lymph follicles. The ventral fascia is, to some extent, fused with the mesocolon descendens on the left side of the body. Notably, the lateral continuation of these two fasciae also sandwiches the left ureter, but not the right ureter, presumably due to modifications by the left-sided fusion fascia. A hypothetical common sheath for the HGN and ureter (i.e., the ureterohypogastric or vesicohypogastric fascia) might thus be an oversimplification. Before retroperitoneal fixation, the morphology of the peritoneal recess along the mesocolon descendens and mesosigmoid suggested interindividual differences in location, shape, and size. Therefore, in adults the ease of surgical separation of the rectum and left-sided colon from the HGN seems to depend on interindividual differences in the development of the embryonic peritoneal recess. On the caudal side of the second sacral segment, fascial structures were restricted along and around the HGN, pelvic splanchnic nerve, and pelvic plexus. The rectal lateral ligament thus seems to represent a kind of migration fascia formed by mechanical stress. Clin. Anat. 21:558,567, 2008. © 2008 Wiley-Liss, Inc. [source] A clinicoanatomical study of the novel nerve fibers linked to stress urinary incontinence: The first morphological description of a nerve descending properly along the anterior vaginal wallCLINICAL ANATOMY, Issue 3 2007Susumu Yoshida Abstract When performing anterior colporrhaphy for cystocele, most pelvic surgeons have not considered the neuroanatomy that contributes to urethral function. The aim of the study was to anatomically identify nerve fibers located in the anterior vagina associated with the pathogenesis of incontinence and pelvic organ prolapse. Anterior vaginal specimens were obtained from 17 female cadavers and 33 cases of clinical cystocele by anterior vaginal resection. The specimens were step-sectioned and stained with hematoxylin-eosin, S100 antibody, and tyrosine hydroxylase antibody. As a result, descending nerves 50,200 ,m in thickness were identified between the urethra and vagina. They were located more than 10 mm medially from a cluster of nerves found almost along the lateral edge of the vagina and stained with S100 and tyrosine hydroxylase antibody, originated from the cranial part of the pelvic plexus, and appeared to terminate at the urethral smooth muscles. The authors classified the density of S100 positive nerve fibers in the anterior vaginal wall obtained from clinically operated cases of cystocele into three grades (Grade 1, nothing or a few thin nerves less than 20 ,m in diameter; Grade 2, thick nerves more than 50 ,m in diameter and thin nerves; Grade 3, more than 3 thick nerves in one field at an objective magnification of 40××). Mean urethral mobility (Q-tip) values (28.1° ±± 19.6°) observed in the Grade 3 cases was significantly lower than those (50.0° ±± 27.4° and 59.4° ±± 19.9°) in Grade 2 and Grade 1, respectively. In addition, the presence of preoperative or postoperative stress urinary incontinence in the cases of Grade 1 was significantly higher than those of the cases with S100 positive stained nerves. In conclusion, the novel nerve fibers immunohistochemically identified in the anterior vaginal wall are different from those of the common nervous system or the pelvic floor and are associated with the pathogenesis of urethral hypermobility. Clin. Anat. 20:300,306, 2007. © 2006 Wiley-Liss, Inc. [source] | |||||||||||||