Objective: To evaluate the feasibility for confirming the preservation of the parasymphathetic nerve pathway innervating the bladder during nerve-sparing radical hysterectomy (RH).
Methods: A total of 20 patients underwent nerve-sparing RH. Intraoperative electrical stimulation (IES) were performed on the root of pelvic splanchnic nerve (PSN) trunk while recording the electromyographic (EMG) activity of the vesical detrusor. The average duration achieving residual urine ≤50 mL and urodynamic study (UDS) was observed.
Results: Evoked potentials were recorded when stimulating, in 18 patients who were referred IES-positive. Its duration was 9.89 days. The UDS results indicated that all voided normally. The remaining 2 IES-negative cases with no evoked potentials had longer duration and the micturitions were performed using abdominal pressure.
Conclusion: During nerve-sparing RH, IES based on the measurement of EMG activity is a useful tool for confirmation of the preservation of parasymphathetic nerve pathway innervating the bladder and prediction of the postoperative bladder function.
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http://dx.doi.org/10.1177/1933719110383969 | DOI Listing |
Neurourol Urodyn
January 2025
Department of Neurology, Hochzirl Hospital, Zirl, Austria.
Introduction: Neurogenic bladder dysfunction is a prevalent condition characterized by impaired bladder control resulting from neurological conditions, for example, spinal cord injury or traumatic brain injury (TBI). Detrusor overactivity is a typical symptom of central nervous system damage. A lesion affecting the pontine neural network typically results in loss of tonic inhibition exerted by the pontine micturition center and causes involuntary detrusor contractions.
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December 2024
Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Introduction: Detrusor contractions can be classified as either volitional or involuntary. The latter are a hallmark of urge urinary incontinence. Understanding differences in neuroactivation associated with both types of contractions can help elucidate pathophysiology and therapeutic targets.
View Article and Find Full Text PDFAbdom Radiol (NY)
December 2024
Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Urinary bladder cancer is a global disease that poses medical and socioeconomic challenges to patients and healthcare systems. Predicting detrusor invasiveness and pathological grade of bladder cancer by the radiologist is imperative for informed decision-making and effective patient-tailored therapy. Cystoscopy and TURBT are the current gold standard for preoperative histologic diagnosis and local pathological staging but are compromised by their intrusiveness, under-sampling, and staging inaccuracies.
View Article and Find Full Text PDFEur J Radiol
December 2024
Department of Internal Medicine, Pathum Thani Hospital, 7 Ladlumkaew Muang district, Pathum Thani 12000, Thailand.
Bladder cancer is categorized into nonmuscle-invasive bladder cancer (NMIBC) and muscle-invasive bladder cancer (MIBC), distinguished by the presence of detrusor muscle invasion. Urothelial cell carcinoma is the most common subtype of bladder cancer. Transurethral resection of bladder tumor (TURBT) is the standard approach for staging and managing NMIBC, while radical cystectomy remains the cornerstone treatment for MIBC.
View Article and Find Full Text PDFUrologiia
May 2024
FGBU Central state medical academy of Administrative Directorate of the President of Russian Federation, Moscow, Russia.
Bladder cancer (BC) is a severe, and in some cases disabling disease for which no active detection strategy has been developed. It requires careful differential diagnosis, and is associated with a high risk for recurrence and progression. The choice of optimal treatment of non-muscle-invasive bladder Cancer (NMIBC) can reduce the rate of recurrence and improve oncologic outcomes.
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