Pudendal nerve exposure and preservation in low rectal surgery by using transvaginal access

Yücesoy, Ali Naki; Poçan, Süheyl; Cifçi, M.; Solmaz, Ali; Serefhan, Alpay

doi:10.1007/s10151-014-1253-6

Cited by 1 publication

(6 citation statements)

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“…Anorectal manometry shows mainly myogenic factors in anorectal functions [20]. There are a few reports on the neurogenic functions of EAS [4] [11] [12]. The regulatory nerve pathway of EAS is the pudendal nerve including both PMN and PSN, which are derived from spinal nerves S2-4 (major regulatory nerves: S3 and S4) [9].…”

Section: Discussionmentioning

confidence: 99%

“…The laten-cy of evoked muscle action responses in EAS (i.e. PMN terminal latency) is recorded after electrical stimulation of PMN in the pelvis [9] [10] [11] [12] [13] [20]. With regard to the PMN terminal latency, artifacts due to pain during evaluations are induced [11] [13].…”

Section: Discussionmentioning

confidence: 99%

“…For investigators employing this technique with inadequate experience, stimulations may not be appropriate. As such, evaluations of the PMN terminal latency may be limited to responses from the ischial spine to EAS, and responses derived from direct stimulations of the EAS muscle may occasionally be evoked [9] [10] [11] [12]. On the other hand, it is possible to use the SMS approach to measure the latency of the whole PMN (the conduction time; extending from the spinal S2-4 motor nerve roots to EAS), and the response is easily induced with high reproducibility, thus providing a reliably consistent index for evaluations [18] [23] [24] [25] [26].…”

Section: Discussionmentioning

confidence: 99%

“…Regarding nerve control of EAS, investigations have mainly focused on EAS regulation by the pudendal motor nerve (PMN) [4] [9] [10] [11]. To date, measurement of the PMN terminal latency has involved direct electrical stimulation of the terminal PMN in the anal canal [9] [10] [11] [12]. There have been many reports of findings obtained on straining during defecation in patients with chronic constipation [13] [14].…”

Section: Introductionmentioning

confidence: 99%

“…Thus, an impaired regulation of EAS by damaged PMN may lead to FI. Regarding studies on PMN terminal latency in LAR patients with soiling or FI, its delay has been suggested [11] [12].…”

Section: Introductionmentioning

confidence: 99%

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Assessments of Pudendal Motor and Sensory Nerves in Patients with or without Fecal Incontinence after Low Anterior Resection for Lower Rectal Cancer

Tomita¹,

Sakurai²,

Fujisaki³

2020

JCT

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Background: To clarify the pudendal motor (PMN) and sensory (PSN) nerves play in preventing fecal incontinence (FI) after low anterior resection (LAR) for lower rectal cancer, the PMN and PSN functions were studied. Methods: Sixty patients were divided into groups A (n = 20, FI) and B (n = 40, continence). These were compared with group C (n = 30, control subjects). PMN latency (PMNL) (right, left, and posterior sides of the anal canal) was studied by sacral magnetic stimulation. Anal mucosal electric sensitivity (AMES) was measured at the lower, dentate line (DL), and upper zones. Results: The distance of anastomosis from anal verge (DAAV) in group A was significantly shorter than in group B (p value < 0.001). In PMNL, the conduction delay in group A was significantly longer than in groups B and C at all sides (p value < 0.001, respectively). On AMES, the sensitivity of patients in group A was significantly lower than in groups B and C at all zones (p value < 0.001, respectively). In groups A, B, and C, correlation coefficients between SMNL (posterior side) and AMES (DL zone) were 0.780, 0.858, and 0.793, respectively (p value < 0.001). Conclusion: FI after LAR with a short DAAV may lead to external anal sphincter dysfunction due to damage of both PMN and PSN.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Thus, an impaired regulation of EAS by damaged PMN may lead to FI. Regarding studies on PMN terminal latency in LAR patients with soiling or FI, its delay has been suggested [11] [12].…”

Section: Introductionmentioning

confidence: 99%

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