Contouring pudendal nerves

Steineck, Gunnar; Bull, Cecilia; Sjöberg, Fei

doi:10.1080/0284186x.2018.1433875

Cited by 2 publications

(2 citation statements)

References 14 publications

(17 reference statements)

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“…A likely explanation for the failure of IMRT to reduce anorectal dysmotility after treatment is that its underlying pathogenesis is damage to neural tissue in the bowel wall and/or the pudendal nerves [2,16]. As discussed in the editorial accompanying the published findings of the final study of this chapter [19], the pudendal nerves are not considered as normal tissues at risk of radiation damage and therefore could potentially receive the same if not higher doses of radiation as the prostate target of irradiation. Radiation dose constraints for normal tissues at risk including the pudendal nerves have been proposed (Section 2.4 above) and if applied now that IMRT has been adopted almost universally, patients who need pelvic radiotherapy for urological and gynecological cancer can look forward to a future free of distressing bowel morbidity.…”

Section: Implications and Summary Of Findings Of Studies And Conclusion(s)mentioning

confidence: 99%

“…However, as muscle tissue particularly striated muscle constituting the EAS is more resistant to radiation damage than neural tissue [2], evidence of pudendal nerve injury after radiotherapy for prostate cancer is presented in the above study [16]. In addition, the editorial accompanying the publication states that the findings show the way forward for the restoration of bowel health of patients who have been adversely affected following pelvic radiotherapy for urological and gynecological malignant diseases [19].…”

Section: Introductionmentioning

confidence: 98%

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Pathophysiology, Natural History and Approaches to Treatment and Prevention of Radiation Proctitis

Yeoh¹

2023

Current Topics in Colorectal Surgery

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Chronic radiation proctitis (CRP), characterized by increased frequency and urgency of defecation, fecal incontinence and rectal bleeding, is an under-estimated cause of morbidity after pelvic irradiation for urological and gynecological malignant diseases. Despite improvements in radiotherapy technology, 90% of patients have persistent long term symptoms and 50% of all patients report impairment of quality of life after pelvic radiotherapy. Research by an Australian group of clinician scientists, including prospective, longitudinal and retrospective studies as well as a randomized trial of two current approaches used for the treatment of haemorrhagic radiation proctitis over a time span exceeding two decades, have provided important insights into the prevalence, pathophysiology natural history and treatment of CRP. The findings have important implications for the management and amelioration if not prevention of CRP. Data from 4 selected studies conducted by the Australian group, each characterizing changes in anorectal function and anal sphincteric morphology, are first presented. This is followed by discussion of how the findings have led to the development of more rational therapeutic interventions for CRP and how novel approaches designed to reduce the prevalence of CRP when combined could lead to its elimination in the foreseeable future.

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Section: Implications and Summary Of Findings Of Studies And Conclusion(s)mentioning

confidence: 99%