Pudendal neuropathy is predictive of failure following anterior overlapping sphincteroplasty

Gilliland, R.; Altomare, Donato F.; Moreira, Hélio; Oliveira, Lúcia Câmara Castro; Gilliland, Janice; Wexner, Steven D.

doi:10.1007/bf02237299

Cited by 229 publications

(111 citation statements)

References 36 publications

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“…In their series, only 16% of patients with pudendal latency greater than 2.2 milliseconds subjectively described their results as successful. Similar results were reported by Sangwan et al (69). The difficulty with interpreting findings in the literature is that no consensus has been reached for agreedupon standard and nonstandard values.…”

Section: Latenza Del Nervo Pudendo (Pntml)supporting

confidence: 85%

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Advanced Diagnostic Testing for Female Pelvic Floor Dysfunctions

Vignoli¹

2010

UIJ

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SUMMARYThe word "pelvic floor dysfunction" has different meanings in different specialties, i.e. radiology, urology, gynaecology, coloproctology. Despite the fact that the concept of perineology is not exactly new, most clinicians have only slowly adapted their practice to this transversal view. The multidisciplinary approach (several specialists dealing with various pelvic floor problems) still prevails over the interdisciplinary one (one specialist explaining what is happening) with several problems in the choice of therapeutic strategies. Obviously, the interdisciplinary approach requires a wide knowledge of the principles and techniques of each specialty. This monographic issue reviews advanced diagnostic testing for female pelvic floor dysfunctions from the perspective of a single specialist, namely a urologist. SOMMARIOIl termine "disfunzione pelvica" riveste un diverso significato nelle diverse specialità. Nonostante, infatti, il concetto di approccio multidisciplinare alle problematiche del pavimento pelvico non sia propriamente nuovo, i clinici si sono dimostrati lenti nell'adattare la propria pratica ad una visione trasversale del problema. L'alternativa alla multidisciplinarietà è l'interdisciplinarietà, nella quale un singolo specialista prende in carico il paziente esaminandolo sotto tutti i punti di vista. È intuitivo che per un simile approccio non si possa prescindere da una conoscenza specifica del bagaglio culturale di ogni singola specialità. Questo numero monografico rappresenta un tentativo di approccio globale alle disfunzioni del pavimento pelvico da parte di un singolo specialista, urologo nella fattispecie.

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Section: Latenza Del Nervo Pudendo (Pntml)supporting

confidence: 85%

“…Ad analoghe conclusioni sono giunti Sangwan e al. (69). C'è però chi sostiene che il negare un intervento di sfinteroplastica sulla base di un alterato tempo di latenza del nervo pudendo sia non etico (70) e l'impiego routinario della metodica nel work-up pre-operatorio sia piuttosto discutibile.…”

Section: Latenza Del Nervo Pudendo (Pntml)unclassified

Advanced Diagnostic Testing for Female Pelvic Floor Dysfunctions

Vignoli¹

2010

UIJ

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“…The working of a predictive score index for the outcome of multimodal rehabilitation would be useful. We will also need to single out the predictive factors [17][18][19]. Facing the extent of these limits, we still believe that our experience can offer some advice and indications, as suggested by our therapeutic results.…”

Section: Discussionmentioning

confidence: 94%

Multimodal rehabilitation for faecal incontinence: experience of an Italian centre devoted to faecal disorder rehabilitation

et al. 2003

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“…La neuropatía pudenda se observa en más del 70% de los pacientes con IF y sobre el 50% de los pacientes con lesión esfi nteriana 13 . Existe controversia respecto a si la prolongación del tiempo de latencia motora pueda predecir malos resultados de la esfi nteroplastía 14 . En la práctica nuestro grupo no dispone de este test y considera, al igual que muchos autores, que no es un examen indispensable en la evaluación de estos pacientes.…”

Section: Latencia De Los Nervios Pudendosunclassified

“…El éxito reportado con esta técnica es de 70 a 90% a corto plazo 27 , lo que disminuye a 50% cuando se evalúa en un período de 5 años 28,29 . Ciertos factores tales como la mayor edad del paciente y la neuropatía de los nervios pudendos pueden ser importantes para predecir falla después de esfi nteroplastía 14 ; si bien la literatura es muy contradictoria al respecto.…”

Section: Esfi Nteroplastíaunclassified

Incontinencia fecal del adulto

A¹,

M²,

G³

et al. 2011

Rev Chil Cir

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Fecal incontinence in adultsThe aim of this paper is to review the knowledge of this pathology by highlighting the clinical evolution, study and treatment. These different aspects need a multidisciplinary approach, because of their complex physiopathology, possible association with urinary incontinence and prolapse of the three compartments of the pelvis. The fecal incontinence (FI) constitutes a highly prevalent pathology that affects at least 2% of the population and up to 45% of the patients in nursing homes. This pathology can cause serious problems in physical, psychological, social, and economical levels. The clinical evaluation may identify or suspect the cause, and guide the study of FI. The initial treatment of the FI should always be medical one, often associated to biofeedback and the surgical treatment should be only reserved for refractory FI. Sphincteroplasty is indicated by defi ned defaults of the external sphincter, with good initial results (at least 70%) that fall to 50% in 5 years. The artifi cial neosphincter and the dynamic graciloplasty represent an option for patient without suffi cient sphincter mass for a plasty. In the last few years new techniques have appear with promising results, as the neuromodulation that uses electrodes in the sacral plexus or applied to the posterior tibial nerve. In conclusion the IF is a problem of large prevalence but kept in shadows because the patients tend to have reticence to declare it, and the doctors to inquire about. The focus should be multidisciplinary and the initial treatment must be medical one. The surgical treatment should be reserved for refractory FI.Key words: Fecal incontinence, endosonography, anal manometry, biofeedback, sphincteroplasty. ResumenEl propósito de esta revisión es actualizar los conocimientos sobre esta patología, destacando su evolución clínica, estudio y tratamiento, aspectos que ameritan un enfoque multidisciplinario, ya que, además de su compleja fi siopatología, puede asociarse a incontinencia urinaria y prolapso de los tres compartimentos de la pelvis. La incontinencia fecal (IF) constituye una patología altamente prevalente que afecta al menos un 2% de la población y hasta el 45% de los pacientes en casas de reposo; cuyas consecuencias pueden ocasionar al paciente serios problemas físicos, psicológicos, sociales y económicos. La evaluación clínica puede identifi car o sospechar la causa de la IF, y guiar el estudio de la misma. El tratamiento inicial de la IF debe ser siempre médico, a menudo asociado a biofeedback, y el tratamiento quirúrgico reservarse para la IF refractaria a estas

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Pudendal neuropathy is predictive of failure following anterior overlapping sphincteroplasty

Abstract: Bilateral normal pudendal nerve terminal motor latencies are the only factors predictive of long-term success after overlapping sphincteroplasty.

Cited by 229 publications

References 36 publications

Advanced Diagnostic Testing for Female Pelvic Floor Dysfunctions

Advanced Diagnostic Testing for Female Pelvic Floor Dysfunctions

Multimodal rehabilitation for faecal incontinence: experience of an Italian centre devoted to faecal disorder rehabilitation

Incontinencia fecal del adulto

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