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• W1989693202 abstract "You have accessJournal of UrologyMale Voiding Dysfunction and Infection1 Apr 2013V410 TIPS FOR PRESERVING PUDENDAL NERVE INNERVATION TO THE MALE URINARY SPHINCTER DURING PELVIC SURGERY Satyan Shah, Trisha Fleet, Maxx Gallegos, and Betty Skipper Satyan ShahSatyan Shah Albuquerque, NM More articles by this author , Trisha FleetTrisha Fleet Albuquerque, NM More articles by this author , Maxx GallegosMaxx Gallegos Albuquerque, NM More articles by this author , and Betty SkipperBetty Skipper Albuquerque, NM More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.1799AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The urinary rhabdosphincter is innervated by branches of the pudendal nerve, but the anatomic course of these nerves is underappreciated. We provide tips on how to identify and preserve these “continence nerves” during pelvic surgery. METHODS Video clips from 7 robotic-assisted radical prostatectomies show keys to successful preservation of pudendal nerve branches to the urinary sphincter: 1) close inspection of the lateral surface of the prostate after opening the endopelvic fascia 2) nerve mobilization outside the layers of periprostatic fascia, prior to potency-nerve sparing 3) identification of associated “worm-like” vasculature and 4) contralateral traction on the lateral surface of the prostate. Because the continence nerves are lateral to the cavernous nerves, a potency-nerve sparing procedure will often result in preservation these “continence nerves”, without formal mobilization. However, the techniques demonstrated in this video are particularly important when the potency nerves are to be widely excised. RESULTS Prospective identification of the continence nerves began with case 87 of our robotic prostatectomy program. Of the 89 subsequent cases through March 2012, the continence nerve(s) were identified and preserved in 50 (56%). Kaplan-Meier analysis showed no difference in the time to recovery of continence, regardless of whether or not the continence nerve(s) had been identified (log rank test, p=0.90). CONCLUSIONS We demonstrate techniques to preserve pudendal nerve innervation responsible for urinary continence. Preservation of these branches may be particularly valuable when the potency nerves are to be widely excised. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e166 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Satyan Shah Albuquerque, NM More articles by this author Trisha Fleet Albuquerque, NM More articles by this author Maxx Gallegos Albuquerque, NM More articles by this author Betty Skipper Albuquerque, NM More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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• W1989693202 title "V410 TIPS FOR PRESERVING PUDENDAL NERVE INNERVATION TO THE MALE URINARY SPHINCTER DURING PELVIC SURGERY" @default.
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