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John Christiansen - One of the best experts on this subject based on the ideXlab platform.
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Pudendal Nerve function in idiopathic fecal incontinence.
Diseases of the colon and rectum, 2000Co-Authors: Ole Ø. Rasmussen, Tine Tetzschner, John Christiansen, Michael SørensenAbstract:PURPOSE: The study was undertaken to determine whether idiopathic fecal incontinence in middle-aged and elderly females is likely to be a result of Pudendal Nerve damage (neurogenic incontinence) or merely a consequence of aging. METHODS: One hundred seventy-eight females over the age of 50 years with fecal incontinence were studied. The incontinence was classified as idiopathic because none of the patients related the incontinence to trauma (including obstetric trauma) or other events or diseases. All had an anal physiology examination, including determination of Nerve conduction velocity of both Pudendal Nerves (Pudendal Nerve terminal motor latency). RESULTS: With a cutoff value of 2.4 msec, 79 percent (95 percent confidence limit, 73–85) had normal Pudendal Nerve terminal motor latency on both sides, 13 bilaterally prolonged latency (7 percent; 4–11), and 25 unilaterally prolonged latency (14 percent; 9–19). With a cutoff value of 2.2 msec, 66 percent (59–73) had normal latency on both sides, 15 percent (9–20) bilaterally prolonged Pudendal Nerve terminal motor latency, and 20 percent (14–26) unilateral prolongation. No relationship between the groups with normal, bilateral, or unilateral prolongation of Pudendal Nerve terminal motor latency and anal resting and squeeze pressure was found. Anal resting pressure decreased with increasing age (P
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delivery and Pudendal Nerve function
Acta Obstetricia et Gynecologica Scandinavica, 1997Co-Authors: Tine Tetzschner, Michael Sørensen, Lisbeth Jønsson, G. Lose, John ChristiansenAbstract:Objective. To assess the impact of mode of delivery and the occurrence of pelvic instability upon the Pudendal Nerve function and relate the Pudendal Nerve function to the occurrence of anal and urinary incontinence. Methods. One hundred and forty-six pregnant women were examined during pregnancy and 12 weeks post partum with measurement of Pudendal Nerve terminal motor latency (PNTML), the difference between the two measurements was defined as ΔPNTML. Anal and urinary continence status, details of delivery and the occurrence of pelvic instability were recorded prospectively. Results. Pudendal Nerve terminal motor latency increased from 1.7 msec in primiparae and 1.8 msec in multiparae during pregnancy to 2.0 msec (p<0.001) and 2.1 (p<0.001) respectively after delivery. The increase was significantly higher after the use of vacuum extraction (p<0.04). Multivariate analysis showed that ΔPNTML was associated with age, the presence of pelvic instability and the use of vacuum extraction. Whereas ΔPNTML was not associated with factors such as infant's head circumference and weight, parity, cesarean section, Pudendal block, epidural analgesia and second stage of labor. Only four women had anal incontinence after delivery. Twenty-five women with urinary incontinence had a significantly higher mean PNTML (2.20 msec) than 121 continent women (2.01 msec). Conclusion. Pudendal Nerve terminal motor latency increases in both primiparous and multiparous women after delivery. In 10% of the women the increase resulted in a pathologic PNTML value >2.4 msec. The ΔPNTML was significantly associated with age, the occurrence of pelvic instability and the use of vacuum extraction. The group of women with urinary incontinence had a significant increased PNTML.
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Delivery and Pudendal Nerve function.
Acta obstetricia et gynecologica Scandinavica, 1997Co-Authors: Tine Tetzschner, Michael Sørensen, Lisbeth Jønsson, G. Lose, John ChristiansenAbstract:Objective. To assess the impact of mode of delivery and the occurrence of pelvic instability upon the Pudendal Nerve function and relate the Pudendal Nerve function to the occurrence of anal and urinary incontinence. Methods. One hundred and forty-six pregnant women were examined during pregnancy and 12 weeks post partum with measurement of Pudendal Nerve terminal motor latency (PNTML), the difference between the two measurements was defined as ΔPNTML. Anal and urinary continence status, details of delivery and the occurrence of pelvic instability were recorded prospectively. Results. Pudendal Nerve terminal motor latency increased from 1.7 msec in primiparae and 1.8 msec in multiparae during pregnancy to 2.0 msec (p
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Vaginal Pudendal Nerve stimulation: a new technique for assessment of Pudendal Nerve terminal motor latency.
Acta obstetricia et gynecologica Scandinavica, 1997Co-Authors: Tine Tetzschner, Michael Sørensen, G. Lose, John ChristiansenAbstract:Background. To evaluate vaginal stimulation of the Pudendal Nerve, a new method for investigation of Pudendal Nerve terminal motor latency (PNTML) and to assess the reproducibility of the method. Methods. Thirteen healthy women and 11 female patients, median age 31 years (range 21–53 years), participated in the study. Ten patients had sustained an anal sphincter rupture and one had idiopathic anal incontinence. Pudendal Nerve terminal motor latency was measured after vaginal stimulation of the Pudendal Nerve with motor response from the pelvic floor and rectal stimulation with motor response from the anal sphincter using the St. Marks Pudendal electrode. The women were stimulated by two observers both vaginally and by the rectum. Results. Vaginal PNTML for observer 1 was 2.06 msec (0.50 msec, 2 s.d.) and 2.04 msec (0.55 msec, 2 s.d.) for observer 2, while rectal PNTML was 1.99 msec (0.56 msec, 2 s.d.) and 1.97 msec (0.54 msec, 2 s.d.) respectively. The difference between vaginal and rectal PNTML was 0.065 msec for observer 1 (p=0.106) and 0.070 msec for observer 2 (p
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Pudendal Nerve function during pregnancy and after delivery
International urogynecology journal and pelvic floor dysfunction, 1997Co-Authors: Tine Tetzschner, Michael Sørensen, G. Lose, John ChristiansenAbstract:The aim of the study was to assess Pudendal Nerve function serially during pregnancy and after delivery. Twenty-eight women participated at 14, 30 and 36 weeks of pregnancy and 12 weeks postpartum. A prospective study of Pudendal Nerve terminal motor latency during pregnancy and after delivery was carried out. Results showed that Pudendal Nerve terminal motor latency did not increase significantly during pregnancy but increased significantly after delivery.
Tine Tetzschner - One of the best experts on this subject based on the ideXlab platform.
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Pudendal Nerve function in idiopathic fecal incontinence.
Diseases of the colon and rectum, 2000Co-Authors: Ole Ø. Rasmussen, Tine Tetzschner, John Christiansen, Michael SørensenAbstract:PURPOSE: The study was undertaken to determine whether idiopathic fecal incontinence in middle-aged and elderly females is likely to be a result of Pudendal Nerve damage (neurogenic incontinence) or merely a consequence of aging. METHODS: One hundred seventy-eight females over the age of 50 years with fecal incontinence were studied. The incontinence was classified as idiopathic because none of the patients related the incontinence to trauma (including obstetric trauma) or other events or diseases. All had an anal physiology examination, including determination of Nerve conduction velocity of both Pudendal Nerves (Pudendal Nerve terminal motor latency). RESULTS: With a cutoff value of 2.4 msec, 79 percent (95 percent confidence limit, 73–85) had normal Pudendal Nerve terminal motor latency on both sides, 13 bilaterally prolonged latency (7 percent; 4–11), and 25 unilaterally prolonged latency (14 percent; 9–19). With a cutoff value of 2.2 msec, 66 percent (59–73) had normal latency on both sides, 15 percent (9–20) bilaterally prolonged Pudendal Nerve terminal motor latency, and 20 percent (14–26) unilateral prolongation. No relationship between the groups with normal, bilateral, or unilateral prolongation of Pudendal Nerve terminal motor latency and anal resting and squeeze pressure was found. Anal resting pressure decreased with increasing age (P
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delivery and Pudendal Nerve function
Acta Obstetricia et Gynecologica Scandinavica, 1997Co-Authors: Tine Tetzschner, Michael Sørensen, Lisbeth Jønsson, G. Lose, John ChristiansenAbstract:Objective. To assess the impact of mode of delivery and the occurrence of pelvic instability upon the Pudendal Nerve function and relate the Pudendal Nerve function to the occurrence of anal and urinary incontinence. Methods. One hundred and forty-six pregnant women were examined during pregnancy and 12 weeks post partum with measurement of Pudendal Nerve terminal motor latency (PNTML), the difference between the two measurements was defined as ΔPNTML. Anal and urinary continence status, details of delivery and the occurrence of pelvic instability were recorded prospectively. Results. Pudendal Nerve terminal motor latency increased from 1.7 msec in primiparae and 1.8 msec in multiparae during pregnancy to 2.0 msec (p<0.001) and 2.1 (p<0.001) respectively after delivery. The increase was significantly higher after the use of vacuum extraction (p<0.04). Multivariate analysis showed that ΔPNTML was associated with age, the presence of pelvic instability and the use of vacuum extraction. Whereas ΔPNTML was not associated with factors such as infant's head circumference and weight, parity, cesarean section, Pudendal block, epidural analgesia and second stage of labor. Only four women had anal incontinence after delivery. Twenty-five women with urinary incontinence had a significantly higher mean PNTML (2.20 msec) than 121 continent women (2.01 msec). Conclusion. Pudendal Nerve terminal motor latency increases in both primiparous and multiparous women after delivery. In 10% of the women the increase resulted in a pathologic PNTML value >2.4 msec. The ΔPNTML was significantly associated with age, the occurrence of pelvic instability and the use of vacuum extraction. The group of women with urinary incontinence had a significant increased PNTML.
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Delivery and Pudendal Nerve function.
Acta obstetricia et gynecologica Scandinavica, 1997Co-Authors: Tine Tetzschner, Michael Sørensen, Lisbeth Jønsson, G. Lose, John ChristiansenAbstract:Objective. To assess the impact of mode of delivery and the occurrence of pelvic instability upon the Pudendal Nerve function and relate the Pudendal Nerve function to the occurrence of anal and urinary incontinence. Methods. One hundred and forty-six pregnant women were examined during pregnancy and 12 weeks post partum with measurement of Pudendal Nerve terminal motor latency (PNTML), the difference between the two measurements was defined as ΔPNTML. Anal and urinary continence status, details of delivery and the occurrence of pelvic instability were recorded prospectively. Results. Pudendal Nerve terminal motor latency increased from 1.7 msec in primiparae and 1.8 msec in multiparae during pregnancy to 2.0 msec (p
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Vaginal Pudendal Nerve stimulation: a new technique for assessment of Pudendal Nerve terminal motor latency.
Acta obstetricia et gynecologica Scandinavica, 1997Co-Authors: Tine Tetzschner, Michael Sørensen, G. Lose, John ChristiansenAbstract:Background. To evaluate vaginal stimulation of the Pudendal Nerve, a new method for investigation of Pudendal Nerve terminal motor latency (PNTML) and to assess the reproducibility of the method. Methods. Thirteen healthy women and 11 female patients, median age 31 years (range 21–53 years), participated in the study. Ten patients had sustained an anal sphincter rupture and one had idiopathic anal incontinence. Pudendal Nerve terminal motor latency was measured after vaginal stimulation of the Pudendal Nerve with motor response from the pelvic floor and rectal stimulation with motor response from the anal sphincter using the St. Marks Pudendal electrode. The women were stimulated by two observers both vaginally and by the rectum. Results. Vaginal PNTML for observer 1 was 2.06 msec (0.50 msec, 2 s.d.) and 2.04 msec (0.55 msec, 2 s.d.) for observer 2, while rectal PNTML was 1.99 msec (0.56 msec, 2 s.d.) and 1.97 msec (0.54 msec, 2 s.d.) respectively. The difference between vaginal and rectal PNTML was 0.065 msec for observer 1 (p=0.106) and 0.070 msec for observer 2 (p
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Pudendal Nerve function during pregnancy and after delivery
International urogynecology journal and pelvic floor dysfunction, 1997Co-Authors: Tine Tetzschner, Michael Sørensen, G. Lose, John ChristiansenAbstract:The aim of the study was to assess Pudendal Nerve function serially during pregnancy and after delivery. Twenty-eight women participated at 14, 30 and 36 weeks of pregnancy and 12 weeks postpartum. A prospective study of Pudendal Nerve terminal motor latency during pregnancy and after delivery was carried out. Results showed that Pudendal Nerve terminal motor latency did not increase significantly during pregnancy but increased significantly after delivery.
P A Lonnqvist - One of the best experts on this subject based on the ideXlab platform.
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Nerve stimulator guided Pudendal Nerve block versus general anesthesia for hemorrhoidectomy.
Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2006Co-Authors: Z Naja, Mariam El-rajab, Mohamad Al-tannir, Fouad Ziade, Riad Zbibo, Mustafa Oweidat, P A LonnqvistAbstract:the hypothesis that patients receiving a Nerve stimulator guided Pudendal Nerve block for hemorrhoidectomy would experience more effective and prolonged postoperative analgesia and shorter hospital stay compared to patients receiving general anesthesia. Methods: This was a prospective randomized observer-blinded study. Following Ethics Committee approval and informed consent, 80 patients scheduled for hemorrhoidectomy were randomized to two groups of 40 patients each: general anesthesia alone, or Nerve stimulator guided Pudendal Nerve block. Postoperative pain, the primary outcome variable of the study, was assessed by visual analogue scale scores at pre-determined intervals during the postoperative period. Analgesic consumption, time to return to normal activities, patients’ and surgeons’ satisfaction, and duration of hospital stay were recorded. Results: The guided Pudendal Nerve block group failed in three patients, requiring their conversion to general anesthesia. Otherwise, patients in the Pudendal Nerve block group experienced better postoperative pain relief at rest (P < 0.0001), on walking, sitting, and defecation (P < 0.001), reduced need for opioids (11/35 vs 32/37; P < 0.0001), a more rapid return to normal activities (7.2 vs 13.8 days; P < 0.0001) and also a shorter hospital stay (25/35 vs 3/37 outpatient cases; P < 0.0001) compared to the general anesthesia group. Pudendal Nerve block was also associated with overall higher patient satisfaction compared to general anesthesia (30/35 vs 9/37; P < 0.0001). Conclusion: Nerve stimulator guided Pudendal Nerve block is associated with reduced postoperative pain, shortened hospital stay, and earlier return to normal activity compared to general anesthesia for hemorrhoidectomy.
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Nerve stimulator guided Pudendal Nerve block decreases posthemorrhoidectomy pain
Canadian Journal of Anaesthesia-journal Canadien D Anesthesie, 2005Co-Authors: Z Naja, M F Ziade, P A LonnqvistAbstract:Purpose Based on our institution’s initial results that reflected reduced postoperative pain using a modified Pudendal Nerve block technique, we conducted a prospective, randomized, double-blind study to investigate whether a combination of general anesthesia and bilateral Nerve stimulator guided Pudendal Nerve blocks could provide better postoperative pain relief compared to general anesthesia alone or in combination with placebo Nerve blocks.
William C. De Groat - One of the best experts on this subject based on the ideXlab platform.
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low pressure voiding induced by a novel implantable Pudendal Nerve stimulator
Neurourology and Urodynamics, 2019Co-Authors: Haotian Cai, Jicheng Wang, James R. Roppolo, William C. De Groat, Tara Nikonow Morgan, Natalie Pace, Bing Shen, Kyle Horlen, Pratap Khanwilkar, Changfeng TaiAbstract:AIM To validate the functionality of an implantable Pudendal Nerve stimulator under development for Food and Drug Administration approval to restore bladder function after spinal cord injury. METHODS In nine cats under anesthesia, two tripolar cuff electrodes were implanted bilaterally on the Pudendal Nerves and one bipolar cuff electrode was implanted on the right Pudendal Nerve central to the tripolar cuff electrode. The Pudendal Nerve stimulator was implanted subcutaneously on the left lower back along the lumbosacral spine and connected to the cuff electrodes. In five cats, a double lumen catheter was inserted into the bladder through the urethra to infuse saline and measure bladder pressure and another catheter was inserted into the distal urethra to perfuse and measure the back pressure caused by urethral contraction. In four cats, a bladder catheter was inserted into the bladder dome and the urethra was left open so that voiding could occur without urethral outlet obstruction. RESULTS The implantable Pudendal Nerve stimulator was controlled wirelessly and successfully provided the required stimulation waveforms to different cuff electrodes. Pudendal Nerve stimulation (PNS) at 5 Hz increased bladder capacity to about 200% of control capacity. PNS at 20 to 30 Hz induced large (80-100 cmH2 O) bladder contractions under isovolumetric conditions. When combined with ipsilateral or bilateral Pudendal Nerve block induced by 6 to 10 kHz stimulation, PNS at 20 to 30 Hz elicited low pressure (<40 cmH 2 O) efficient (70%) voiding. CONCLUSIONS The implantable stimulator generated the required stimulation waveforms and successfully induced low pressure efficient voiding in anesthetized cats.
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Low pressure voiding induced by a novel implantable Pudendal Nerve stimulator.
Neurourology and urodynamics, 2019Co-Authors: Haotian Cai, Jicheng Wang, James R. Roppolo, William C. De Groat, Tara Nikonow Morgan, Natalie Pace, Bing Shen, Kyle Horlen, Pratap Khanwilkar, Changfeng TaiAbstract:AIM To validate the functionality of an implantable Pudendal Nerve stimulator under development for Food and Drug Administration approval to restore bladder function after spinal cord injury. METHODS In nine cats under anesthesia, two tripolar cuff electrodes were implanted bilaterally on the Pudendal Nerves and one bipolar cuff electrode was implanted on the right Pudendal Nerve central to the tripolar cuff electrode. The Pudendal Nerve stimulator was implanted subcutaneously on the left lower back along the lumbosacral spine and connected to the cuff electrodes. In five cats, a double lumen catheter was inserted into the bladder through the urethra to infuse saline and measure bladder pressure and another catheter was inserted into the distal urethra to perfuse and measure the back pressure caused by urethral contraction. In four cats, a bladder catheter was inserted into the bladder dome and the urethra was left open so that voiding could occur without urethral outlet obstruction. RESULTS The implantable Pudendal Nerve stimulator was controlled wirelessly and successfully provided the required stimulation waveforms to different cuff electrodes. Pudendal Nerve stimulation (PNS) at 5 Hz increased bladder capacity to about 200% of control capacity. PNS at 20 to 30 Hz induced large (80-100 cmH2 O) bladder contractions under isovolumetric conditions. When combined with ipsilateral or bilateral Pudendal Nerve block induced by 6 to 10 kHz stimulation, PNS at 20 to 30 Hz elicited low pressure (
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Influence of temperature on Pudendal Nerve block induced by high frequency biphasic electrical current.
The Journal of urology, 2008Co-Authors: Changfeng Tai, Jicheng Wang, Michael B. Chancellor, James R. Roppolo, William C. De GroatAbstract:Purpose: We determined the influence of temperature on the minimal stimulation frequency required to block Pudendal Nerve conduction.Materials and Methods: The Pudendal Nerve block induced by high frequency, biphasic electrical current was investigated at different temperatures using cats under α-chloralose anesthesia. Urethral pressure was measured to indicate Pudendal Nerve activation or block.Results: As stimulation frequency was increased above a frequency threshold, the urethral pressure response was decreased and the Pudendal Nerve was blocked. The minimal stimulation frequency required to block the Pudendal Nerve was decreased from 6 to 4 kHz as the temperature was decreased from 37C to 15C. At a 4 kHz frequency the maximal temperature below which the Pudendal Nerve could be blocked was 24.5C.Conclusions: To block Pudendal Nerve conduction at body temperature (37C) the stimulation frequency must be greater than 6 kHz. This study provides a practical guide for blocking the Pudendal Nerves to restore...
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bladder inhibition or voiding induced by Pudendal Nerve stimulation in chronic spinal cord injured cats
Neurourology and Urodynamics, 2007Co-Authors: Jicheng Wang, William C. De Groat, Xianchun Wang, James R. RoppoloAbstract:Aims To investigate Pudendal-to-bladder spinal reflexes in chronic spinal cord injured (SCI) cats induced by electrical stimulation of the Pudendal Nerve. Methods Bladder inhibition or voiding induced by Pudendal Nerve stimulation at different frequencies (3 or 20 Hz) was studied in three female, chronic SCI cats under α-chloralose anesthesia. Results Voiding induced by a slow infusion (2–4 ml/min) of saline into the bladder was very inefficient (voiding efficiency = 7.3% ± 0.9%). Pudendal Nerve stimulation at 3 Hz applied during the slow infusion inhibited reflex bladder activity, and significantly increased bladder capacity to 147.2 ± 6.1% of its control capacity. When the 3-Hz stimulation was terminated, voiding rapidly occurred and the voiding efficiency was increased to 25.4 ± 6.1%, but residual bladder volume was not reduced. Pudendal Nerve stimulation at 20 Hz induced large bladder contractions, but failed to induce voiding during the stimulation due to the direct activation of the motor pathway to the external urethral sphincter. However, intermittent Pudendal Nerve stimulation at 20 Hz induced post-stimulus voiding with 78.3 ± 12.1% voiding efficiency. The voiding pressures (39.3 ± 6.2 cmH2O) induced by the intermittent Pudendal Nerve stimulation were higher than the voiding pressures (23.1 ± 1.7 cmH2O) induced by bladder distension. The flow rate during post-stimulus voiding induced by the intermittent Pudendal Nerve stimulation was significantly higher (0.93 ± 0.04 ml/sec) than during voiding induced by bladder distension (0.23 ± 0.07 ml/sec). Conclusions This study indicates that a neural prosthetic device based on Pudendal Nerve stimulation might be developed to restore micturition function for people with SCI. Neurourol. Urodynam. 26:570–577, 2007. © 2007 Wiley-Liss, Inc.
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external urethral sphincter activity in a rat model of Pudendal Nerve injury
Neurourology and Urodynamics, 2006Co-Authors: Chihwei Peng, Hui Yi Chang, William C. De Groat, Jia Jin Jason Chen, Chen Li ChengAbstract:Aims Pudendal Nerve injury in the rat has been a useful animal model for studying stress urinary incontinence (SUI). However, the effect of Pudendal Nerve injury on activity of the external urethral sphincter (EUS) is relatively unexplored. The aims of this study were to examine voiding and the EUS electromyogram (EMG) in a durable SUI model in rats with bilateral or unilateral Pudendal Nerve transections. In addition, the effects of denervation on urethral anatomy were investigated. Methods A leak point pressure (LPP) test was first used to demonstrate that Pudendal Nerve transection induced SUI. Cystometry exhibited changes in voiding function and EUS-EMG measurements provided a quantitative evaluation of EUS activity during voiding. The morphological changes in sections through the mid-urethra were assessed with hematoxylin and eosin (H&E) staining. Results A significant decrease in average LPP was detected in rats 6 weeks after bilateral Pudendal Nerve transection (BPNT). Abnormal urodynamic measurements including a decrease in contraction amplitude and voided volume as well as an increase in contraction duration, and residual volume all indicated inefficient voiding. In addition EUS-EMG silent periods were reduced and the frequency of EUS-EMG bursting during voiding was increased. Atrophy of striated muscle in the EUS was also detected in rats with Pudendal Nerve transection(s). Conclusions Our results indicate that Pudendal Nerve transection in rats decreases urethral outlet resistance and causes striated muscle atrophy in the EUS, EUS-EMG abnormalities and inefficient voiding. The results demonstrate that BPNT is a durable model for SUI. Neurourol. Urodynam. © 2006 Wiley-Liss, Inc.
Michael Sørensen - One of the best experts on this subject based on the ideXlab platform.
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Pudendal Nerve function in idiopathic fecal incontinence.
Diseases of the colon and rectum, 2000Co-Authors: Ole Ø. Rasmussen, Tine Tetzschner, John Christiansen, Michael SørensenAbstract:PURPOSE: The study was undertaken to determine whether idiopathic fecal incontinence in middle-aged and elderly females is likely to be a result of Pudendal Nerve damage (neurogenic incontinence) or merely a consequence of aging. METHODS: One hundred seventy-eight females over the age of 50 years with fecal incontinence were studied. The incontinence was classified as idiopathic because none of the patients related the incontinence to trauma (including obstetric trauma) or other events or diseases. All had an anal physiology examination, including determination of Nerve conduction velocity of both Pudendal Nerves (Pudendal Nerve terminal motor latency). RESULTS: With a cutoff value of 2.4 msec, 79 percent (95 percent confidence limit, 73–85) had normal Pudendal Nerve terminal motor latency on both sides, 13 bilaterally prolonged latency (7 percent; 4–11), and 25 unilaterally prolonged latency (14 percent; 9–19). With a cutoff value of 2.2 msec, 66 percent (59–73) had normal latency on both sides, 15 percent (9–20) bilaterally prolonged Pudendal Nerve terminal motor latency, and 20 percent (14–26) unilateral prolongation. No relationship between the groups with normal, bilateral, or unilateral prolongation of Pudendal Nerve terminal motor latency and anal resting and squeeze pressure was found. Anal resting pressure decreased with increasing age (P
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delivery and Pudendal Nerve function
Acta Obstetricia et Gynecologica Scandinavica, 1997Co-Authors: Tine Tetzschner, Michael Sørensen, Lisbeth Jønsson, G. Lose, John ChristiansenAbstract:Objective. To assess the impact of mode of delivery and the occurrence of pelvic instability upon the Pudendal Nerve function and relate the Pudendal Nerve function to the occurrence of anal and urinary incontinence. Methods. One hundred and forty-six pregnant women were examined during pregnancy and 12 weeks post partum with measurement of Pudendal Nerve terminal motor latency (PNTML), the difference between the two measurements was defined as ΔPNTML. Anal and urinary continence status, details of delivery and the occurrence of pelvic instability were recorded prospectively. Results. Pudendal Nerve terminal motor latency increased from 1.7 msec in primiparae and 1.8 msec in multiparae during pregnancy to 2.0 msec (p<0.001) and 2.1 (p<0.001) respectively after delivery. The increase was significantly higher after the use of vacuum extraction (p<0.04). Multivariate analysis showed that ΔPNTML was associated with age, the presence of pelvic instability and the use of vacuum extraction. Whereas ΔPNTML was not associated with factors such as infant's head circumference and weight, parity, cesarean section, Pudendal block, epidural analgesia and second stage of labor. Only four women had anal incontinence after delivery. Twenty-five women with urinary incontinence had a significantly higher mean PNTML (2.20 msec) than 121 continent women (2.01 msec). Conclusion. Pudendal Nerve terminal motor latency increases in both primiparous and multiparous women after delivery. In 10% of the women the increase resulted in a pathologic PNTML value >2.4 msec. The ΔPNTML was significantly associated with age, the occurrence of pelvic instability and the use of vacuum extraction. The group of women with urinary incontinence had a significant increased PNTML.
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Delivery and Pudendal Nerve function.
Acta obstetricia et gynecologica Scandinavica, 1997Co-Authors: Tine Tetzschner, Michael Sørensen, Lisbeth Jønsson, G. Lose, John ChristiansenAbstract:Objective. To assess the impact of mode of delivery and the occurrence of pelvic instability upon the Pudendal Nerve function and relate the Pudendal Nerve function to the occurrence of anal and urinary incontinence. Methods. One hundred and forty-six pregnant women were examined during pregnancy and 12 weeks post partum with measurement of Pudendal Nerve terminal motor latency (PNTML), the difference between the two measurements was defined as ΔPNTML. Anal and urinary continence status, details of delivery and the occurrence of pelvic instability were recorded prospectively. Results. Pudendal Nerve terminal motor latency increased from 1.7 msec in primiparae and 1.8 msec in multiparae during pregnancy to 2.0 msec (p
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Vaginal Pudendal Nerve stimulation: a new technique for assessment of Pudendal Nerve terminal motor latency.
Acta obstetricia et gynecologica Scandinavica, 1997Co-Authors: Tine Tetzschner, Michael Sørensen, G. Lose, John ChristiansenAbstract:Background. To evaluate vaginal stimulation of the Pudendal Nerve, a new method for investigation of Pudendal Nerve terminal motor latency (PNTML) and to assess the reproducibility of the method. Methods. Thirteen healthy women and 11 female patients, median age 31 years (range 21–53 years), participated in the study. Ten patients had sustained an anal sphincter rupture and one had idiopathic anal incontinence. Pudendal Nerve terminal motor latency was measured after vaginal stimulation of the Pudendal Nerve with motor response from the pelvic floor and rectal stimulation with motor response from the anal sphincter using the St. Marks Pudendal electrode. The women were stimulated by two observers both vaginally and by the rectum. Results. Vaginal PNTML for observer 1 was 2.06 msec (0.50 msec, 2 s.d.) and 2.04 msec (0.55 msec, 2 s.d.) for observer 2, while rectal PNTML was 1.99 msec (0.56 msec, 2 s.d.) and 1.97 msec (0.54 msec, 2 s.d.) respectively. The difference between vaginal and rectal PNTML was 0.065 msec for observer 1 (p=0.106) and 0.070 msec for observer 2 (p
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Pudendal Nerve function during pregnancy and after delivery
International urogynecology journal and pelvic floor dysfunction, 1997Co-Authors: Tine Tetzschner, Michael Sørensen, G. Lose, John ChristiansenAbstract:The aim of the study was to assess Pudendal Nerve function serially during pregnancy and after delivery. Twenty-eight women participated at 14, 30 and 36 weeks of pregnancy and 12 weeks postpartum. A prospective study of Pudendal Nerve terminal motor latency during pregnancy and after delivery was carried out. Results showed that Pudendal Nerve terminal motor latency did not increase significantly during pregnancy but increased significantly after delivery.
