Assessment of feasibility of neuronal reinnervation of pudendal nerve by femoral nerve’s motor branch to vastus lateralis: an ultrasound-guided study

2020 ◽  
Vol 43 (6) ◽  
pp. 779-784
Author(s):  
Pawan Agarwal ◽  
Geetesh Ratre ◽  
Sanjoy Pandey ◽  
D. Sharma
Keyword(s):  
Pudendal Nerve ◽  
Vastus Lateralis ◽  
Ultrasound Guided ◽  
Motor Branch

scholarly journals Accuracy of Ultrasound-Guided Pudendal Nerve Block in the Ischial Spine and Alcock’s Canal Levels: A Cadaveric Study

Pain Medicine ◽  
2020 ◽  
Vol 21 (11) ◽  
pp. 2692-2698
Author(s):  
Béatrice Soucy ◽  
Dien Hung Luong ◽  
Johan Michaud ◽  
Mathieu Boudier-Revéret ◽  
Stéphane Sobczak
Keyword(s):  
Pudendal Nerve ◽  
Ischial Spine ◽  
Ultrasound Guided ◽  
Us Guidance ◽  
Significant Difference ◽  
Alcock’S Canal ◽  
The Difference ◽  
One Year ◽  
Musculoskeletal Us ◽  
Different Levels

Abstract Background Blockade of the pudendal nerve (PN) using ultrasound (US) guidance has been described at the levels of the ischial spine and Alcock’s canal. However, no study has been conducted to compare anatomical accuracy between different approaches in targeting the PN. Objective To investigate the accuracy of US-guided injection of the PN at the ischial spine and Alcock’s canal levels. This study also compared the accuracy of the infiltrations by three sonographers with different levels of experience. Subjects Eight Thiel-embalmed cadavers (16 hemipelvises). Methods Three physiatrists trained in musculoskeletal US imaging with 12 years, five years, and one year of experience performed the injections. Each injected a 0.1-mL bolus of colored dye in both hemipelvises of each cadaver at the ischial spine and Alcock’s canal levels under US guidance. Each cadaver received three injections per hemipelvis. The accuracy of the injection was determined following hemipelvis dissection by an anatomist. Results The injections were accurate 33 times out of the total 42 attempts, resulting in 78% accuracy. Sixteen out of 21 injections at the ischial spine level were on target (76% accuracy), while the approach at Alcock’s canal level yielded 17 successful injections (81% accuracy). The difference between the approaches was not statistically significant. There was also no significant difference in accuracy between the operators. Conclusions US-guided injection of the PN can be performed accurately at both the ischial spine and Alcock’s canal levels. The difference between the approaches was not statistically significant.

scholarly journals Ultrasound-Guided Pudendal Nerve Block Combined with Propofol Deep Sedation versus Spinal Anesthesia for Hemorrhoidectomy: A Prospective Randomized Study

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Jian He ◽  
Lei Zhang ◽  
Dong L. Li ◽  
Wan Y. He ◽  
Qing M. Xiong ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Intensity ◽  
Spinal Anesthesia ◽  
Urinary Retention ◽  
Nerve Block ◽  
Pudendal Nerve ◽  
Deep Sedation ◽  
Randomized Study ◽  
Prospective Randomized Study ◽  
Ultrasound Guided

Background and Objectives. Several anesthesia techniques were applied to hemorrhoidectomy, but postoperative pain and urinary retention were still two unsolved problems. The aim of this prospective randomized study was to evaluate the effect of ultrasound-guided pudendal nerve block (PNB) combined with deep sedation compared to spinal anesthesia for hemorrhoidectomy. Methods. One hundred and twenty patients undergoing Milligan–Morgan hemorrhoidectomy were randomized to receive PNB combined with deep sedation using propofol (Group PNB, n = 60) or spinal anesthesia (Group SA, n = 60). Pain intensity was assessed using the visual analogue scale (0: no pain to 10: worst possible pain). The primary outcome was pain scores recorded at rest at 3, 6, 12, 24, 36, and 48 h and on walking at 12, 24, 36, and 48 h postoperatively. Secondary outcomes were analgesic consumption, side effects, and patient satisfaction after surgery. Results. Ultrasound-guided bilateral PNB combined with deep sedation using propofol could successfully be applied to Milligan–Morgan hemorrhoidectomy. Postoperative pain intensity was significantly lower in Group PNB compared to Group SA at rest at 3, 6, 12, 24, 36, and 48 h ( p < 0.001 ) and during mobilization at 12, 24, 36, and 48 h ( p < 0.001 ) postoperatively. Sufentanil consumption in Group PNB was significantly lower than that in Group SA, during 0–24 h ( p < 0.001 ) and during 24–48 h ( p < 0.001 ) postoperatively. Urinary retention was significantly lower in Group PNB compared to Group SA (6.9% vs 20%, p = 0.034 ). The patients in Group PNB had higher satisfaction compared to Group SA ( p < 0.001 ). Conclusions. Ultrasound-guided PNB combined with propofol sedation is an effective anesthesia technique for Milligan–Morgan hemorrhoidectomy.

The pudendal nerve motor branch regenerates via a brain derived neurotrophic factor mediated mechanism

2020 ◽  
Vol 334 ◽  
pp. 113438
Author(s):  
Brian M. Balog ◽  
Tessa Askew ◽  
Dan Li Lin ◽  
Mei Kuang ◽  
Brett Hanzlicek ◽  
...  
Keyword(s):  
Neurotrophic Factor ◽  
Pudendal Nerve ◽  
Brain Derived Neurotrophic Factor ◽  
Motor Branch

Ultrasound-guided transgluteal injection of the pudendal nerve in cats: a cadaveric study

2021 ◽  
Vol 48 (6) ◽  
pp. S985
Author(s):  
J. Briley ◽  
E. Keenihan ◽  
K. Mathews ◽  
L. Chiavaccini
Keyword(s):  
Pudendal Nerve ◽  
Cadaveric Study ◽  
Ultrasound Guided

New, simple, ultrasound-guided infiltration of the pudendal nerve

2001 ◽  
Vol 44 (9) ◽  
pp. 1381-1385 ◽  
Author(s):  
Peter Kovacs ◽  
Hannes Gruber ◽  
Johannes Piegger ◽  
Gerd Bodner
Keyword(s):  
Pudendal Nerve ◽  
Ultrasound Guided

scholarly journals The effects of neuromodulation in a novel obese-prone rat model of detrusor underactivity

2017 ◽  
Vol 313 (3) ◽  
pp. F815-F825 ◽  
Author(s):  
Eric J. Gonzalez ◽  
Warren M. Grill
Keyword(s):  
Electrical Stimulation ◽  
Urinary Retention ◽  
Pudendal Nerve ◽  
Bladder Function ◽  
Lower Urinary Tract Dysfunction ◽  
Detrusor Underactivity ◽  
Motor Branch ◽  
Detrusor Contractility ◽  
Increased Risk ◽  
Stimulation Of

Obesity is a global epidemic associated with an increased risk for lower urinary tract dysfunction. Inefficient voiding and urinary retention may arise in late-stage obesity when the expulsive force of the detrusor smooth muscle cannot overcome outlet resistance. Detrusor underactivity (DUA) and impaired contractility may contribute to the pathogenesis of nonobstructive urinary retention. We used cystometry and electrical stimulation of peripheral nerves (pudendal and pelvic nerves) to characterize and improve bladder function in urethane-anesthetized obese-prone (OP) and obese-resistant (OR) rats following diet-induced obesity (DIO). OP rats exhibited urinary retention and impaired detrusor contractility following DIO, reflected as increased volume threshold, decreased peak micturition pressure, and decreased voiding efficiency (VE) compared with OR rats. Electrical stimulation of the sensory branch of the pudendal nerve did not increase VE, whereas patterned bursting stimulation of the motor branch of the pudendal nerve increased VE twofold in OP rats. OP rats required increased amplitude of electrical stimulation of the pelvic nerve to elicit bladder contractions, and maximum evoked bladder contraction amplitudes were decreased relative to OR rats. Collectively, these studies characterize a novel animal model of DUA that can be used to determine pathophysiology and suggest that neuromodulation is a potential management option for DUA.

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