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Journal of Medicine and Life 2015Pelvic exenteration remains one of the most destructive surgical procedures in gynecologic oncology, performed in patients with locally advanced malignancies who were... (Review)
Review
Pelvic exenteration remains one of the most destructive surgical procedures in gynecologic oncology, performed in patients with locally advanced malignancies who were considered for a long time as unresectable. However, for these patients, an aggressive surgical approach seems to be the only potential curative solution. This is a literature review of the most important studies, which analyzes the benefits and the secondary risks of this demanding procedure.
Topics: Female; Genital Neoplasms, Female; Humans; Pelvic Exenteration; Pelvis
PubMed: 25866569
DOI: No ID Found -
International Braz J Urol : Official... 2023The objective of the present study is to evaluate the anatomy of the inferior hypogastric plexus, correlating it with urological pathologies, imaging exams and surgeries... (Review)
Review
OBJECTIVE
The objective of the present study is to evaluate the anatomy of the inferior hypogastric plexus, correlating it with urological pathologies, imaging exams and surgeries of the female pelvis, especially for treatment of endometriosis.
MATERIAL AND METHODS
We carried out a review about the anatomy of the inferior hypogastric plexus in the female pelvis. We analyzed papers published in the past 20 years in the databases of Pubmed, Embase and Scielo, and we included only papers in English and excluded case reports, editorials, and opinions of specialists. We also studied two human fixed female corpses and microsurgical dissection material with a stereoscopic magnifying glass with 2.5x magnification.
RESULTS
Classical anatomical studies provide few details of the morphology of the inferior hypogastric plexus (IHP) or the location and nature of the associated nerves. The fusion of pelvic splanchnic nerves, sacral splanchnic nerves, and superior hypogastric plexus together with visceral afferent fibers form the IHP. The surgeon's precise knowledge of the anatomical relationship between the hypogastric nerve and the uterosacral ligament is essential to reduce the risk of complications and postoperative morbidity of patients surgically treated for deep infiltrative endometriosis involving the uterosacral ligament.
CONCLUSION
Accurate knowledge of the innervation of the female pelvis is of fundamental importance for prevention of possible injuries and voiding dysfunctions as well as the evacuation mechanism in the postoperative period. Imaging exams such as nuclear magnetic resonance are interesting tools for more accurate visualization of the distribution of the hypogastric plexus in the female pelvis.
Topics: Humans; Female; Hypogastric Plexus; Endometriosis; Pelvis; Uterus; Cadaver
PubMed: 36515618
DOI: 10.1590/S1677-5538.IBJU.2022.9980 -
Der Orthopade Oct 2020The field of musculoskeletal diagnostics and personalized medicine has undergone a revolutionary transformation due to a deeper understanding of skeletal biomechanics... (Review)
Review
The field of musculoskeletal diagnostics and personalized medicine has undergone a revolutionary transformation due to a deeper understanding of skeletal biomechanics and due to technological advancements. Analogous to this transformation, our understanding of spinopelvic conditions has experienced a paradigm shift in terms of both static and dynamic changes in spinopelvic pathologies and enabled a more accurate delineation of the drivers of disability. The purpose of this review is to describe the standard and state of the art of preoperative diagnostic and planning methods for common spinopelvic pathologies and to discuss both the added clinical value and limitations. The rationale is to accelerate the accurate and timely diagnosis and as well as the efficient and safe preoperative workflow.
Topics: Humans; Pelvis; Preoperative Period; Spine
PubMed: 32944784
DOI: 10.1007/s00132-020-03982-w -
Seminars in Ultrasound, CT, and MR Jun 2017Chronic pelvic pain syndrome is commonly caused by nerve injury, inflammation, or entrapment. Owing to the complex anatomy and branching patterns of pelvic nerves,... (Review)
Review
Chronic pelvic pain syndrome is commonly caused by nerve injury, inflammation, or entrapment. Owing to the complex anatomy and branching patterns of pelvic nerves, pelvic neuropathies are often difficult to illustrate and diagnose. High-resolution 3-T magnetic resonance neurography is a promising technique for the evaluation of peripheral neuropathy. In this article, the authors discuss the normal anatomy of major pelvic nerves, technical considerations of high-resolution imaging, and normal and abnormal imaging appearances with relevant case examples.
Topics: Chronic Pain; Humans; Magnetic Resonance Imaging; Pelvic Pain; Pelvis; Peripheral Nervous System Diseases
PubMed: 28705371
DOI: 10.1053/j.sult.2016.11.006 -
International Journal of Gynecological... Sep 2019The primary objective of this review was to study and analyze techniques of nerve-sparing radical hysterectomy so as to be able to characterize and elucidate intricate... (Review)
Review
AIM
The primary objective of this review was to study and analyze techniques of nerve-sparing radical hysterectomy so as to be able to characterize and elucidate intricate steps for the dissection of each component of the pelvic autonomic nerve plexuses during nerve-sparing radical hysterectomy.
METHODS
This review was based on a five-step study design that included searching for relevant publications, selecting publications by applying inclusion and exclusion criteria, quality assessment of the identified studies, data extraction, and data synthesis.
RESULTS
There are numerous differences in the published literature concerning nerve-sparing radical hysterectomy including variations in techniques and surgical approaches. Techniques that claim to be nerve-sparing by staying above the dissection level of the hypogastric nerves do not highlight the pelvic splanchnic nerve, do not take into account the intra-operative patient position, nor the fact that the bladder branches leave the inferior hypogastric plexus in a ventrocranial direction, and the fact that inferior hypogastric plexus will be drawn cranially with the vaginal walls (if this is not recognized and isolated earlier) above the level of hypogastric nerves by drawing the uterus cranially during the operation.
CONCLUSIONS
The optimal nerve-sparing radical hysterectomy technique has to be radical (type C1) and must describe surgical steps to highlight all three components of the pelvic autonomic nervous system (hypogastric nerves, pelvic splanchnic nerves, and the bladder branches of the inferior hypogastric plexus). Recognizing the pelvic splanchnic nerves in the caudal parametrium and the isolation of the bladder branches of the inferior hypogastic plexus requires meticulous preparation of the caudal part of the ventral parametrium.
Topics: Female; Humans; Hypogastric Plexus; Hysterectomy; Pelvis; Splanchnic Nerves; Urinary Bladder
PubMed: 31326949
DOI: 10.1136/ijgc-2019-000410 -
World Journal of Surgical Oncology Feb 2023Due to the fixed bony structure of the pelvis, the pelvic operation space is limited, complicating the surgical operation of rectal cancer, especially middle and low... (Review)
Review
Due to the fixed bony structure of the pelvis, the pelvic operation space is limited, complicating the surgical operation of rectal cancer, especially middle and low rectal cancer. The closer the tumor is to the anal verge, the smaller the operative field and operating space, the longer the operative time, and the greater the incidence of intraoperative side injuries and postoperative complications. To date, there is still no clear definition of a difficult pelvis that affects the surgical operation of rectal cancer. Few related research reports exist in the literature, and views on this aspect are not the same between countries. Therefore, it is particularly important to predict the difficulty of rectal cancer surgery in a certain way before surgery and to select the surgical method most suitable for each case during the treatment of rectal cancer.
Topics: Humans; Laparoscopy; Pelvis; Rectal Neoplasms; Rectum; Anal Canal; Treatment Outcome
PubMed: 36843078
DOI: 10.1186/s12957-023-02933-x -
Journal of Clinical Neurophysiology :... Aug 2014Currently, the means to assess the autonomic nervous system primarily depend on end organ functional measurement: intravesical pressure, skin resistance, and penile... (Review)
Review
Currently, the means to assess the autonomic nervous system primarily depend on end organ functional measurement: intravesical pressure, skin resistance, and penile strain gauge tension, for example. None of these measures has been generally accepted in the operating room. Nevertheless, the segmental and peripheral pelvic autonomic nerve supply is placed at risk during both pelvic and lower spine surgery. In this difficult era of suboptimal post-prostatectomy outcomes, the urological literature does reveal the salutary development of safer dissection techniques about the peri-prostatic and cavernous plexus. Means of reliably specific nerve identification remain elusive. The need for actual nerve monitoring (not just identification) has only recently been proposed. Data from the animal lab reinforce an appreciation of the intimate and elegant interconnectedness of autonomic and somatic structures, particularly at the segmental level. Also, the biochemistry of erectile tissue engorgement (in both sexes) is very well understood (the electrophysiology increasingly so). Understanding these principles should permit parallel investigation and implementation of neurophysiological techniques which both identify and monitor pelvic autonomic function. The predicates for these proposed new approaches in the operating room are discussed in this review.
Topics: Autonomic Nervous System; Humans; Monitoring, Intraoperative; Pelvis; Spinal Cord
PubMed: 25083841
DOI: 10.1097/WNP.0000000000000055 -
Tropical Doctor Oct 2020Pyomyositis commonly presents with fever, muscle pain and abscess formation involving deep soft-tissue compartments. is the main causative organism and diagnosis is...
Pyomyositis commonly presents with fever, muscle pain and abscess formation involving deep soft-tissue compartments. is the main causative organism and diagnosis is usually established clinically, supported by imaging, but confirmation may be achieved by histopathological examination. Broad-spectrum antibiotic therapy and surgical debridement are the cornerstone of treatment. Its prognosis is good but, as in all soft-tissue infections, it depends on early intervention, directed antibiotics and, if indicated, prompt surgery. In this paper, we describe a case of pelvic pyomyositis complicated with bacteraemia and bilateral septic pulmonary emboli in a young man in Colombia.
Topics: Anti-Bacterial Agents; Bacteremia; Colombia; Humans; Magnetic Resonance Imaging; Male; Pelvis; Pulmonary Embolism; Pyomyositis; Staphylococcal Infections; Staphylococcus aureus; Young Adult
PubMed: 32623976
DOI: 10.1177/0049475520938166 -
Clinical Obstetrics and Gynecology Mar 2017This article provides an overview of ultrasonographic evaluation of the normal female pelvis. Pertinent pelvic anatomy is reviewed, and there is an in-depth discussion... (Review)
Review
This article provides an overview of ultrasonographic evaluation of the normal female pelvis. Pertinent pelvic anatomy is reviewed, and there is an in-depth discussion of the normal appearance of the uterus and ovaries. In addition, the indications and technique for performing 3-dimensional imaging and saline-infused sonohysterography are covered.
Topics: Female; Humans; Imaging, Three-Dimensional; Ovary; Pelvis; Sodium Chloride; Ultrasonography; Uterus
PubMed: 28005593
DOI: 10.1097/GRF.0000000000000259 -
Current Sports Medicine Reports Aug 2023
Topics: Humans; Thigh; Pelvis; Hip Injuries; Hip Joint
PubMed: 37549209
DOI: 10.1249/JSR.0000000000001086