Biomaterial Database

Anorectal and bladder function after sacrifice of the sacral nerves. 2000

S Nakai, and H Yoshizawa, and S Kobayashi, and K Maeda, and Y Okumura

Departments of Orthopedic Surgery, Fujita Health University, School of Medicine, Kutsukakecho, Toyoake-City, Aichi-Prefecture, Japan. nakai@fujita-hu.ac.jp

METHODS The quantitative changes in anorectal and bladder functions after sacrifice of the sacral nerves were assessed. OBJECTIVE To evaluate the bladder and anorectal functions before and after sacral nerve division in patients with sacral bone tumors. BACKGROUND The quantitative changes in bladder and anorectal functions after sacrifice of the sacral nerves have not been intensively studied. The purpose of this investigation was to measure the bladder and anorectal function before and after sacral nerve division using manometry and cystometry. METHODS Surgical resection of a sacral tumor was performed in five patients. The sacral nerves were sacrificed bilaterally in three patients and unilaterally in two patients. Anorectal function was evaluated on the basis of symptoms and physiologic tests. Micturition function was evaluated based on symptoms, and intravesical pressures were measured by cystometry. RESULTS The two patients with unilateral sacral nerve loss did not experience subjective problems with defecation or micturition, although the residual volume of urine was increased after surgery. Two of the three patients with bilateral sacral nerve loss had no urge to defecate, were unable to differentiate between feces and flatus, and experienced no urgency. Fecal incontinence was uncommon because of firm feces. It was possible to control defecation using enemas on alternate days. The third patient underwent colostomy because the maximum resting pressure, which is controlled by the hypogastric nerves, was affected before surgery. CONCLUSIONS Unilateral sacrifice of sacral nerves results in little bladder or anorectal dysfunction.

UI	MeSH Term	Description	Entries
D007001	Hypogastric Plexus	A complex network of nerve fibers in the pelvic region. The hypogastric plexus distributes sympathetic fibers from the lumbar paravertebral ganglia and the aortic plexus, parasympathetic fibers from the pelvic nerve, and visceral afferents. The bilateral pelvic plexus is in its lateral extent.	Pelvic Plexus,Plexus, Hypogastric,Plexus, Pelvic
D008160	Lumbosacral Plexus	The lumbar and sacral plexuses taken together. The fibers of the lumbosacral plexus originate in the lumbar and upper sacral spinal cord (L1 to S3) and innervate the lower extremities.	Inferior Cluneal Nerves,Lumbar Plexus,Posterior Femoral Cutaneous Nerve,Sacral Plexus,Cluneal Nerve, Inferior,Cluneal Nerves, Inferior,Inferior Cluneal Nerve,Nerve, Inferior Cluneal,Nerves, Inferior Cluneal,Plexus, Lumbar,Plexus, Lumbosacral,Plexus, Sacral
D008297	Male		Males
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D011183	Postoperative Complications	Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.	Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D012007	Rectum	The distal segment of the LARGE INTESTINE, between the SIGMOID COLON and the ANAL CANAL.	Rectums
D001743	Urinary Bladder	A musculomembranous sac along the URINARY TRACT. URINE flows from the KIDNEYS into the bladder via the ureters (URETER), and is held there until URINATION.	Bladder,Bladder Detrusor Muscle,Detrusor Urinae,Bladder Detrusor Muscles,Bladder, Urinary,Detrusor Muscle, Bladder,Detrusor Muscles, Bladder
D001750	Urinary Bladder, Neurogenic	Dysfunction of the URINARY BLADDER due to disease of the central or peripheral nervous system pathways involved in the control of URINATION. This is often associated with SPINAL CORD DISEASES, but may also be caused by BRAIN DISEASES or PERIPHERAL NERVE DISEASES.	Bladder Disorder, Neurogenic,Neurogenic Bladder,Bladder Neurogenesis,Bladder, Neurogenic,Neurogenic Bladder Disorder,Neurogenic Bladder, Atonic,Neurogenic Bladder, Spastic,Neurogenic Bladder, Uninhibited,Neurogenic Dysfunction of the Urinary Bladder,Neurogenic Urinary Bladder Disorder,Neurogenic Urinary Bladder, Atonic,Neurogenic Urinary Bladder, Spastic,Neurogenic Urinary Bladder, Uninhibited,Neuropathic Bladder,Urinary Bladder Disorder, Neurogenic,Urinary Bladder Neurogenesis,Urinary Bladder Neurogenic Dysfunction,Atonic Neurogenic Bladder,Neurogenesis, Bladder,Neurogenesis, Urinary Bladder,Neurogenic Bladder Disorders,Neurogenic Urinary Bladder,Spastic Neurogenic Bladder,Uninhibited Neurogenic Bladder
D003714	Denervation	The resection or removal of the nerve to an organ or part.	Laser Neurectomy,Neurectomy,Peripheral Neurectomy,Radiofrequency Neurotomy,Denervations,Laser Neurectomies,Neurectomies,Neurectomies, Laser,Neurectomies, Peripheral,Neurectomy, Laser,Neurectomy, Peripheral,Neurotomies, Radiofrequency,Neurotomy, Radiofrequency,Peripheral Neurectomies,Radiofrequency Neurotomies
D005242	Fecal Incontinence	Failure of voluntary control of the anal sphincters, with involuntary passage of feces and flatus.	Bowel Incontinence,Fecal Soiling,Incontinence, Bowel,Incontinence, Fecal,Soilings, Fecal