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Keywords = bladder nerve branches

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16 pages, 10018 KB  
Article
Variations and Asymmetry in Sacral Ventral Rami Contributions to the Bladder
by Rebeccah R. Overton, Istvan P. Tamas, Emily P. Day, Nagat Frara, Michel A. Pontari, Susan B. Fecho, Steven N. Popoff and Mary F. Barbe
Diagnostics 2025, 15(1), 102; https://doi.org/10.3390/diagnostics15010102 - 3 Jan 2025
Cited by 2 | Viewed by 2320
Abstract
Background/Objectives: We have demonstrated in human cadavers and canines that nerve transfer to bladder vesical nerve branches is technically feasible for bladder reinnervation after nerve injury. We further clarify here that sacral (S) ventral rami contribute to these vesical branches in 36 pelvic [...] Read more.
Background/Objectives: We have demonstrated in human cadavers and canines that nerve transfer to bladder vesical nerve branches is technically feasible for bladder reinnervation after nerve injury. We further clarify here that sacral (S) ventral rami contribute to these vesical branches in 36 pelvic sides (in 22 human cadavers). Methods: Gross post-mortem visualization and open anterior abdominal approaches were used, as was micro-CT of sacral nerve bundles, for further confirmation when needed. Results: Considerable between and within-subject variation was observed. Sacral (S) ventral rami contributions to vesical nerves were observed as shared contributions from several rami or, in a few cases, from single rami: S2 alone (6%), S3 alone (6%), S2 and S3 (28%), S3 and S4 (28%), S2–S4, 14%, L5 in combination with S1–S4 (6%), S1 and S2 (6%), and S3–S5 (3%). The most common contributor to these shared or single rami contributions was from the S3 ventral ramus, which contributed 100% of the time on the left side and 79% on the right side. Side-to-side asymmetry was observed in 10 of 14 cadavers examined bilaterally (71%). Conclusions: This characterization of the anatomical variation in sacral ventral rami contributions to the bladder will ultimately aid in developing therapeutics for patients with bladder dysfunction. Full article
(This article belongs to the Special Issue Advances in Anatomy—Third Edition)
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17 pages, 56086 KB  
Article
Anatomical Location of the Vesical Branches of the Inferior Hypogastric Plexus in Human Cadavers
by Emily P. Day, Benjamin R. Johnston, Stanley F. Bazarek, Justin M. Brown, Nucelio Lemos, Eve I. Gibson, Helaina N. Hurban, Susan B. Fecho, Lewis Holt-Bright, Daniel D. Eun, Michel A. Pontari, Elise J. De, Francis J. McGovern, Michael R. Ruggieri and Mary F. Barbe
Diagnostics 2024, 14(8), 794; https://doi.org/10.3390/diagnostics14080794 - 10 Apr 2024
Cited by 5 | Viewed by 4068
Abstract
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. [...] Read more.
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. Full article
(This article belongs to the Special Issue Advances in Anatomy—Third Edition)
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25 pages, 32444 KB  
Review
Surgical Anatomy and Dissection of the Hypogastric Plexus in Nerve-Sparing Radical Hysterectomy
by Stoyan Kostov, Yavor Kornovski, Angel Yordanov, Rafał Watrowski, Stanislav Slavchev, Yonka Ivanova, Tosho Ganev, Hakan Yalçın and Ilker Selçuk
Diagnostics 2024, 14(1), 83; https://doi.org/10.3390/diagnostics14010083 - 29 Dec 2023
Cited by 7 | Viewed by 7965
Abstract
Radical hysterectomy is a central surgical procedure in gynecological oncology. A nerve-sparing approach is essential to minimize complications from iatrogenic injury to the pelvic nerves, resulting in postoperative urinary, anorectal, and sexual dysfunction. The hypogastric plexus (HP), a complex network of sympathetic and [...] Read more.
Radical hysterectomy is a central surgical procedure in gynecological oncology. A nerve-sparing approach is essential to minimize complications from iatrogenic injury to the pelvic nerves, resulting in postoperative urinary, anorectal, and sexual dysfunction. The hypogastric plexus (HP), a complex network of sympathetic and parasympathetic nerves, plays a critical role in pelvic autonomic innervation. This article offers a comprehensive overview of the surgical anatomy of the HP and provides a step-by-step description of HP dissection, with a particular emphasis on preserving the bladder nerve branches of the inferior HP. A thorough understanding and mastery of the anatomical and surgical nuances of HP dissection are crucial for optimizing outcomes in nerve-sparing gynecologic-oncological procedures. Full article
(This article belongs to the Special Issue Advances in Anatomy—Third Edition)
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