Proteomic Analysis of Pelvic Autonomic Nerve in Nerve-sparing Radical Hysterectomy for Cervical Carcinoma

Lee, Yoon Hee; Kim, Min Kyung; Moon, Hee Young; Chong, Gun Oh; Lee, Hyun Jung; Park, Ji Young; Lee, Chan Hyeong; Baek, Moon Chang; Hong, Dae Gy

doi:10.21873/cgp.20092

Cited by 4 publications

(3 citation statements)

References 16 publications

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“…Because of the close proximity of the paracervix and supporting tissues around the uterus with the pelvic nerves, the integrity of pelvic innervation may be compromised during RH [22]. Although no significant differences between patients who underwent nerve-sparing procedures and those who underwent non-nerve-sparing procedures were observed in our study, some studies have demonstrated that nerve-sparing techniques appear to improve bladder function without compromising overall survival [23]. Ditto et al [24] reported a significant difference between patients undergoing nerve-sparing RH and patients undergoing non-nerve-sparing RH.…”

Section: Discussioncontrasting

confidence: 54%

Assessment of Pelvic Floor Function and Quality of Life in Patients Treated for Cervical Cancer: A Multicenter Retrospective Study

Wang

Wen

Gao

et al. 2021

Gynecol Obstet Invest

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Objectives: Our study aimed to evaluate the quality of life (QoL) and pelvic floor function of cervical cancer (CC) patients after treatment. Design: This was a cross-sectional observational cohort study. Participants: The participants included in this study were CC patients who underwent radical hysterectomy (RH) from 2012 to 2018 at 18 medical centers across China. Methods: The validated versions of the Pelvic floor Distress Inventory-Short Form 20, Overactive Bladder Symptom Score, and Euro Qol Five-Dimension questionnaires were used to evaluate postoperative pelvic floor dysfunction (PFD) and QoL. Results: A total of 689 CC patients were enrolled. The incidence of stress urinary incontinence (SUI), incomplete urinary emptying, and constipation were 32.7, 27.7, and 28.6%, respectively. Multivariate analysis confirmed that laparoscopic RH (LRH) and vaginal wall resection greater than 3 cm were risk factors for lower urinary tract symptoms (LUTS). LRH and chemotherapy were risk factors for SUI. Chemoradiotherapy and LRH were risk factors for overactive bladder (OAB). A high body mass index and LRH were risk factors for more severe defecation symptoms. ARH and large amount of operative blood loss were risk factors for poor QoL. Conclusion: PFD is common in CC patients after treatment. LRH seems to increase the postoperative distress, including LUTS and defecation symptoms. Postoperative urinary incontinence and OAB are more bothersome for patients undergoing chemotherapy and radiotherapy. We recommend evaluating pelvic floor function as a standard assessment during follow-up.

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Section: Discussioncontrasting

confidence: 54%

Assessment of Pelvic Floor Function and Quality of Life in Patients Treated for Cervical Cancer: A Multicenter Retrospective Study

Wang

Wen

Gao

et al. 2021

Gynecol Obstet Invest

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“…These findings suggest difficulties in identifying the IHP. In a report studying the proteomic analysis of the pelvic autonomic nerve, both soft tissue and vesical branch of the IHP nerve from five women were collected during surgery, and the existence of nerve fiber was not confirmed in one case (20%) 25 . A report determined the nerve area density in cross sections of resected parametria at various distances from the cervix using a point counting technique.…”

Section: Discussionmentioning

confidence: 99%

Identification and injury to the inferior hypogastric plexus in nerve-sparing radical hysterectomy

Wang

et al. 2019

Sci Rep

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Waterjet dissection of the inferior hypogastric plexus (IHP) resulted in a more rapid return of normal urodynamics than blunt dissection (control group) in patients who received laparoscopic nerve-sparing radical hysterectomy (NSRH) in a randomized controlled study. However, the definite reasons for these results were unknown. This subgroup analysis compared the neural areas and impairment in the IHP uterine branches harvested during NSRH as an alternative to the IHP vesical branches between the waterjet and control groups. This study included samples from 30 eligible patients in each group of the trial NCT03020238. At least one specimen from each side of the IHP uterine branches was resected. The tissues were scanned, images were captured, and the neural component areas were calculated using the image segmentation method. Immunohistochemical staining was used to evaluate neural impairment. The control and waterjet groups had similar areas of whole tissues sent for evaluation. However, the control group had significantly fewer areas (median 272158 versus 200439 μm2, p = 0.044) and a lower percentage (median 4.9% versus 3.0%, p = 0.011) of neural tissues. No significant changes in immunohistochemical staining were found between the two groups. For patients with residual urine ≤100 and >100 ml at 14 days after NSRH (42 and 18 patients, respectively), there were significantly different percentages of neural tissues in the resected samples (p < 0.001). Hence, Due to the accurate identification of IHP during NSRH, the waterjet dissection technique achieved better urodynamic results.

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“…Sympathetic sacral splanchnic nerves from sacral located sympathetic ganglia also send branches into the IHP [9][10][11]. The anterior division of the IHP supplies nerve fibers to the bladder and ureter (i.e., vesical branches of the IHP, also known as vesical branches of the pelvic nerve [12][13][14][15][16], anterior branches of the IHP [9,17,18], and bladder nerve branches [10]). The anterior division of the IHP also supplies nerve branches to the uterus and vagina, or prostate [7]; see [9][10][11] for more regarding the anatomy of this entire plexus.…”

Section: Introductionmentioning

confidence: 99%

Anatomical Location of the Vesical Branches of the Inferior Hypogastric Plexus in Human Cadavers

Day,

Johnston,

Bazarek

et al. 2024

Diagnostics

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We have demonstrated in canines that somatic nerve transfer to vesical branches of the inferior hypogastric plexus (IHP) can be used for bladder reinnervation after spinal root injury. Yet, the complex anatomy of the IHP hinders the clinical application of this repair strategy. Here, using human cadavers, we clarify the spatial relationships of the vesical branches of the IHP and nearby pelvic ganglia, with the ureteral orifice of the bladder. Forty-four pelvic regions were examined in 30 human cadavers. Gross post-mortem and intra-operative approaches (open anterior abdominal, manual laparoscopic, and robot-assisted) were used. Nerve branch distances and diameters were measured after thorough visual inspection and gentle dissection, so as to not distort tissue. The IHP had between 1 to 4 vesical branches (2.33 ± 0.72, mean ± SD) with average diameters of 0.51 ± 0.06 mm. Vesical branches from the IHP arose from a grossly visible pelvic ganglion in 93% of cases (confirmed histologically). The pelvic ganglion was typically located 7.11 ± 6.11 mm posterolateral to the ureteral orifice in 69% of specimens. With this in-depth characterization, vesical branches from the IHP can be safely located both posterolateral to the ureteral orifice and emanating from a more proximal ganglionic enlargement during surgical procedures.

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Proteomic Analysis of Pelvic Autonomic Nerve in Nerve-sparing Radical Hysterectomy for Cervical Carcinoma

Abstract: Abstract. Background

Cited by 4 publications

References 16 publications

Assessment of Pelvic Floor Function and Quality of Life in Patients Treated for Cervical Cancer: A Multicenter Retrospective Study

Assessment of Pelvic Floor Function and Quality of Life in Patients Treated for Cervical Cancer: A Multicenter Retrospective Study

Identification and injury to the inferior hypogastric plexus in nerve-sparing radical hysterectomy

Anatomical Location of the Vesical Branches of the Inferior Hypogastric Plexus in Human Cadavers

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