Please use this identifier to cite or link to this item: http://hdl.handle.net/11434/732
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dc.contributor.authorMurphy, Declan-
dc.contributor.authorCorcoran, Niall-
dc.contributor.authorCostello, Anthony-
dc.contributor.otherReeves, Fairleigh-
dc.contributor.otherEveraerts, Wouter-
dc.contributor.otherKiers, Lynette-
dc.contributor.otherPeters, Justin-
dc.contributor.otherCostello, Tim-
dc.date2015-10-
dc.date.accessioned2016-08-30T00:49:13Z-
dc.date.available2016-08-30T00:49:13Z-
dc.date.issued2016-01-
dc.identifier.citationUrology. 2016 Jan;87:133-9en_US
dc.identifier.issn0090-4295en_US
dc.identifier.urihttp://hdl.handle.net/11434/732-
dc.description.abstractOBJECTIVE: To use nerve conduction studies to clarify the functional innervation of the male urethral rhabdosphincter (RS). In particular, to test the hypothesis that in some men, fibers of the neurovascular bundle supply the RS. These fibers may be at risk during radical prostatectomy. MATERIALS AND METHODS: Men undergoing robot-assisted radical prostatectomy for clinically localized prostate cancer were included. Men with a history of pelvic surgery and/or radiation and/or trauma, obesity, or neurological diseases were excluded. Nerve conduction studies were performed before and after prostate removal. The St. Mark's pudendal electrode was used for pudendal (control) stimulation. The ProPep Nerve-Monitoring System (ProPep Surgical, Austin, TX) was used to stimulate the neurovascular bundle at the level of the prostate base, mid, and apex. ProPep needle electrodes inserted into the RS were used to measure evoked compound motor action potential response. Results were only included if a valid pudendal control was elicited. RESULTS: Seventeen men in total underwent investigation. Valid measurements were obtained after initial quality control in seven. In two cases, evidence of sphincteric activation was observed, providing evidence to support neurovascular bundle innervation of the RS. In the other five patients, no intrapelvic nerve supply was demonstrated. CONCLUSION: Somatic nerve supply to the RS is variable. Direct intrapelvic supply to the RS may exist in some men. This may be one explanation as to why some patients unexpectedly develop severe urinary incontinence postoperatively despite technically satisfactory surgery. Further research is required to validate our findingsen_US
dc.publisherElsevieren_US
dc.subjectProstate Canceren_US
dc.subjectRadical Prostatectomyen_US
dc.subjectUrethral Rhabdosphincteren_US
dc.subjectNeurovascular Bundleen_US
dc.subjectRobot-Assisted Radical Prostatectomyen_US
dc.subjectRARPen_US
dc.subjectNerve Conductionen_US
dc.subjectProPep Nerve-Monitoring Systemen_US
dc.subjectPudendal Controlen_US
dc.subjectIntrapelvic Nerve Supplyen_US
dc.subjectSomatic Nerve Supplyen_US
dc.subjectUrinary Incontinenceen_US
dc.subjectEpworth Prostate Centre, Epworth Healthcare, Melbourneen_US
dc.titleStimulation of the neurovascular bundle results in rhabdosphincter contraction in a proportion of men undergoing radical prostatectomy.en_US
dc.typeJournal Articleen_US
dc.identifier.doi10.1016/j.urology.2015.09.016en_US
dc.identifier.journaltitleUrologyen_US
dc.description.pubmedurihttp://www.ncbi.nlm.nih.gov/pubmed/26456743en_US
dc.description.affiliatesDepartment of Urology and Surgery, University of Melbourne, The Royal Melbourne Hospital, Melbourne, Australiaen_US
dc.description.affiliatesDivision of Cancer Surgery, Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, Australiaen_US
dc.description.affiliatesDepartment of Neurology, The Royal Melbourne Hospital, Melbourne, Australiaen_US
dc.description.affiliatesDepartment of Anaesthesia, St Vincent's Hospital, Melbourne, Australiaen_US
dc.type.studyortrialControlled Clinical Trialen_US
dc.type.contenttypeTexten_US
Appears in Collections:Cancer Services
Epworth Prostate Centre
Neurosciences
UroRenal, Vascular

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