The Experts below are selected from a list of 24846 Experts worldwide ranked by ideXlab platform
Cornelis J. H Van De Velde - One of the best experts on this subject based on the ideXlab platform.
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Urinary and sexual Dysfunction after rectal cancer treatment
Nature Reviews Urology, 2011Co-Authors: M M Lange, Cornelis J. H Van De VeldeAbstract:In light of the improving prognosis for patients with rectal cancer, the quality of functional outcome has become increasingly important. Despite the good functional results achieved by expert surgeons, large multicenter studies show that urogenital Dysfunction remains a common problem after rectal cancer treatment. More than half of patients experience a deterioration in sexual function, consisting of ejaculatory problems and impotence in men and vaginal dryness and dyspareunia in women. Urinary Dysfunction occurs in one-third of patients treated for rectal cancer. Surgical nerve damage is the main cause of Urinary Dysfunction. Radiotherapy seems to have a role in the development of sexual Dysfunction, without affecting Urinary function. Pelvic autonomic nerves are especially at risk in cases of low rectal cancer and during abdominoperineal resection. Data concerning nerve damage during laparoscopic surgery for resection of rectal cancer are awaited. Structured education of surgeons with regard to pelvic neuroanatomy, and systematic registration of identified nerves, could well be the key to improving functional outcome for these patients. Meanwhile, patients should be informed of all associated risks before their operation, and their functional status should be evaluated before and after surgery.
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causes of fecal and Urinary incontinence after total mesorectal excision for rectal cancer based on cadaveric surgery a study from the cooperative clinical investigators of the dutch total mesorectal excision trial
Journal of Clinical Oncology, 2008Co-Authors: Christian Wallner, Wouter H. Lamers, M M Lange, Bert A Bonsing, Cornelis P Maas, Charles Wallace, Noshir F Dabhoiwala, Harm J Rutten, Marco C Deruiter, Cornelis J. H Van De VeldeAbstract:Purpose Total mesorectal excision (TME) for rectal cancer may result in anorectal and urogenital Dysfunction. We aimed to study possible nerve disruption during TME and its consequences for functional outcome. Because the levator ani muscle plays an important role in both Urinary and fecal continence, an explanation could be peroperative damage of the nerve supply to the levator ani muscle. Methods TME was performed on cadaver pelves. Subsequently, the anatomy of the pelvic floor innervation and its relation to the pelvic autonomic innervation and the mesorectum were studied. Additionally, data from the Dutch TME trial were analyzed to relate anorectal and Urinary Dysfunction to possible nerve damage during TME procedure. Results Cadaver TME surgery demonstrated that, especially in low tumors, the pelvic floor innervation can be damaged. Furthermore, the origin of the levator ani nerve was located in close proximity of the origin of the pelvic splanchnic nerves. Analysis of the TME trial data showed that ...
M M Lange - One of the best experts on this subject based on the ideXlab platform.
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Urinary and sexual Dysfunction after rectal cancer treatment
Nature Reviews Urology, 2011Co-Authors: M M Lange, Cornelis J. H Van De VeldeAbstract:In light of the improving prognosis for patients with rectal cancer, the quality of functional outcome has become increasingly important. Despite the good functional results achieved by expert surgeons, large multicenter studies show that urogenital Dysfunction remains a common problem after rectal cancer treatment. More than half of patients experience a deterioration in sexual function, consisting of ejaculatory problems and impotence in men and vaginal dryness and dyspareunia in women. Urinary Dysfunction occurs in one-third of patients treated for rectal cancer. Surgical nerve damage is the main cause of Urinary Dysfunction. Radiotherapy seems to have a role in the development of sexual Dysfunction, without affecting Urinary function. Pelvic autonomic nerves are especially at risk in cases of low rectal cancer and during abdominoperineal resection. Data concerning nerve damage during laparoscopic surgery for resection of rectal cancer are awaited. Structured education of surgeons with regard to pelvic neuroanatomy, and systematic registration of identified nerves, could well be the key to improving functional outcome for these patients. Meanwhile, patients should be informed of all associated risks before their operation, and their functional status should be evaluated before and after surgery.
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causes of fecal and Urinary incontinence after total mesorectal excision for rectal cancer based on cadaveric surgery a study from the cooperative clinical investigators of the dutch total mesorectal excision trial
Journal of Clinical Oncology, 2008Co-Authors: Christian Wallner, Wouter H. Lamers, M M Lange, Bert A Bonsing, Cornelis P Maas, Charles Wallace, Noshir F Dabhoiwala, Harm J Rutten, Marco C Deruiter, Cornelis J. H Van De VeldeAbstract:Purpose Total mesorectal excision (TME) for rectal cancer may result in anorectal and urogenital Dysfunction. We aimed to study possible nerve disruption during TME and its consequences for functional outcome. Because the levator ani muscle plays an important role in both Urinary and fecal continence, an explanation could be peroperative damage of the nerve supply to the levator ani muscle. Methods TME was performed on cadaver pelves. Subsequently, the anatomy of the pelvic floor innervation and its relation to the pelvic autonomic innervation and the mesorectum were studied. Additionally, data from the Dutch TME trial were analyzed to relate anorectal and Urinary Dysfunction to possible nerve damage during TME procedure. Results Cadaver TME surgery demonstrated that, especially in low tumors, the pelvic floor innervation can be damaged. Furthermore, the origin of the levator ani nerve was located in close proximity of the origin of the pelvic splanchnic nerves. Analysis of the TME trial data showed that ...
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Urinary Dysfunction after rectal cancer treatment is mainly caused by surgery
British Journal of Surgery, 2008Co-Authors: M M Lange, C P Maas, Corrie A M Marijnen, T Wiggers, Heidi Rutten, Klein E Kranenbarg, C J H Van De VeldeAbstract:Background. Urinary Dysfunction (UD) is common after rectal cancer treatment, but the contribution of each treatment component (surgery and radiotherapy) to its development remains unclear. This study aimed to evaluate UD during 5 years after total mesorectal excision (TME) and to investigate the influence of preoperative radiotherapy (PRT) and surgical factors. Methods: Patients with operable rectal cancer were randomized to TME with or without PRT. Questionnaires concerning UD were completed by 785 patients before and at several time points after surgery. Possible risk factors, including PRT, demographics, tumour location, and type and extent of resection, were investigated by multivariable regression analysis. Results: Long-term incontinence was reported by 38.1 percent of patients, of whom 72.0 percent had normal preoperative function. Preoperative incontinence (relative risk (RR) 2.75, P = 0.001) and female sex (RR 2.77, P <0.001) were independent risk factors. Long-term difficulty in bladder emptying was reported by 30.6 per cent of patients, of whom 65.0 per cent had normal preoperative function. Preoperative difficulty in bladder emptying (RR 2.94, P <0.001), peroperative blood loss (RR 1.73, P = 0.028) and autonomic nerve damage (RR 2.82, P = 0.024) were independent risk factors. PRT was not associated with UD. Conclusion: UD is a significant clinical problem after rectal cancer treatment and is not related to PRT, but rather to surgical nerve damage.
Yoshihiro Akazai - One of the best experts on this subject based on the ideXlab platform.
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Urinary Dysfunction after rectal cancer surgery results from a randomized trial comparing mesorectal excision with and without lateral lymph node dissection for clinical stage ii or iii lower rectal cancer japan clinical oncology group study jcog0212
Ejso, 2018Co-Authors: Masaaki Ito, Akihiro Kobayashi, Shin Fujita, Junki Mizusawa, Yukihide Kanemitsu, Yusuke Kinugasa, Koji Komori, Masayuki Ohue, Mitsuyoshi Ota, Yoshihiro AkazaiAbstract:Abstract Background Postoperative Urinary Dysfunction is a major complication of rectal cancer surgery. A randomized controlled trial (JCOG0212) concluded that the noninferiority of mesorectal excision alone to mesorectal excision with lateral lymph node dissection was not confirmed in terms of relapse-free survival. Methods Eligibility criteria included histologically proven clinical stage II/III rectal cancer, a main lesion located in the rectum with the lower margin below the peritoneal reflection, and the absence of lateral lymph node enlargement. After confirming R0 resection by mesorectal excision, patients were randomized intraoperatively. The residual urine volume was measured three times. Urinary Dysfunction was defined as ≥50 mL residual urine occurring at least once or no measurement of residual Urinary volume. This trial was registered with the UMIN Clinical Trials Registry, number C000000034. Results In the mesorectal excision alone and the mesorectal excision with lateral lymph node dissection groups, the incidence of early Urinary Dysfunction were 58% and 59%, respectively. A tumor location in the lower rectum (vs. upper rectum) and a blood loss of ≥500 mL (vs. Conclusions Mesorectal excision with lateral lymph node dissection is not associated with a significant increase in the incidence of Urinary Dysfunction. Urinary Dysfunction is associated with tumor location and blood loss.
Masaaki Ito - One of the best experts on this subject based on the ideXlab platform.
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Urinary Dysfunction after rectal cancer surgery results from a randomized trial comparing mesorectal excision with and without lateral lymph node dissection for clinical stage ii or iii lower rectal cancer japan clinical oncology group study jcog0212
Ejso, 2018Co-Authors: Masaaki Ito, Akihiro Kobayashi, Shin Fujita, Junki Mizusawa, Yukihide Kanemitsu, Yusuke Kinugasa, Koji Komori, Masayuki Ohue, Mitsuyoshi Ota, Yoshihiro AkazaiAbstract:Abstract Background Postoperative Urinary Dysfunction is a major complication of rectal cancer surgery. A randomized controlled trial (JCOG0212) concluded that the noninferiority of mesorectal excision alone to mesorectal excision with lateral lymph node dissection was not confirmed in terms of relapse-free survival. Methods Eligibility criteria included histologically proven clinical stage II/III rectal cancer, a main lesion located in the rectum with the lower margin below the peritoneal reflection, and the absence of lateral lymph node enlargement. After confirming R0 resection by mesorectal excision, patients were randomized intraoperatively. The residual urine volume was measured three times. Urinary Dysfunction was defined as ≥50 mL residual urine occurring at least once or no measurement of residual Urinary volume. This trial was registered with the UMIN Clinical Trials Registry, number C000000034. Results In the mesorectal excision alone and the mesorectal excision with lateral lymph node dissection groups, the incidence of early Urinary Dysfunction were 58% and 59%, respectively. A tumor location in the lower rectum (vs. upper rectum) and a blood loss of ≥500 mL (vs. Conclusions Mesorectal excision with lateral lymph node dissection is not associated with a significant increase in the incidence of Urinary Dysfunction. Urinary Dysfunction is associated with tumor location and blood loss.
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Morphological study of the neurovascular bundle to elucidate nerve damage in pelvic surgery.
International journal of colorectal disease, 2015Co-Authors: Mitsutaka Nishimura, Yuji Nishizawa, Munekazu Naito, Shuichi Hirai, Masahiro Itoh, Masaaki Ito, Shintaro Akamoto, Yasuyuki SuzukiAbstract:Purpose Postoperative sexual and Urinary Dysfunction may occur after rectal cancer surgery involving the pelvis, but this problem cannot be solved. The aim of this study was to examine the nerve morphology of the neurovascular bundle in cadavers to determine possible causes of nerve damage during surgery.
Praveen Thumbikat - One of the best experts on this subject based on the ideXlab platform.
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mast cell function in prostate inflammation fibrosis and smooth muscle cell Dysfunction
American Journal of Physiology-renal Physiology, 2021Co-Authors: Goutham Pattabiraman, Ashlee J Bellcohn, Stephen F Murphy, Daniel J Mazur, Anthony J Schaeffer, Praveen ThumbikatAbstract:Intraurethral inoculation of mice with uropathogenic E. coli (CP1) results in prostate inflammation, fibrosis, and Urinary Dysfunction, recapitulating some but not all of the pathognomonic clinical features associated with benign prostatic hyperplasia (BPH) and lower Urinary tract symptoms (LUTS). In both patients with LUTS and in CP1-infected mice, we observed increased numbers and activation of mast cells and elevated levels of prostate fibrosis. Therapeutic inhibition of mast cells using a combination of mast cell stabilizer (MCS), cromolyn sodium, and the histamine 1 receptor antagonist (H1RA), cetirizine di-hydrochloride, in the mouse model resulted in reduced mast cell activation in the prostate and significant alleviation of Urinary Dysfunction. Treated mice showed reduced prostate fibrosis, less infiltration of immune cells, and decreased inflammation. In addition, as opposed to symptomatic CP1-infected mice, treated mice showed reduced myosin light chain (MLC)-2 phosphorylation, a marker of prostate smooth muscle contraction. These results show that mast cells play a critical role in the pathophysiology of Urinary Dysfunction and may be an important therapeutic target for men with BPH/LUTS.
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mast cell function in prostate inflammation fibrosis and smooth muscle cell Dysfunction
bioRxiv, 2021Co-Authors: Goutham Pattabiraman, Ashlee J Bellcohn, Stephen F Murphy, Daniel J Mazur, Anthony J Schaeffer, Praveen ThumbikatAbstract:ABSTRACT Intraurethral inoculation of mice with uropathogenic E. coli (CP1) results in prostate inflammation, fibrosis, and Urinary Dysfunction, recapitulating some but not all of the pathognomonic clinical features associated with benign prostatic hyperplasia (BPH) and lower Urinary tract symptoms (LUTS). In both patients with LUTS and in CP1-infected mice, we observed increased numbers and activation of mast cells and elevated levels of prostate fibrosis. Therapeutic inhibition of mast cells and the histamine 1 receptor in the mouse model resulted in reduced mast cell activation in the prostate and significant alleviation of Urinary Dysfunction. Treated mice showed reduced prostate fibrosis, less infiltration of immune cells, and decreased inflammation. In addition, as opposed to symptomatic CP1-infected mice, treated mice showed reduced myosin light chain (MLC)-2 phosphorylation, a marker of prostate smooth muscle contraction. These results show that mast cells play a critical role in the pathophysiology of Urinary Dysfunction and may be an important therapeutic target for men with BPH/LUTS. NEW AND NOTEWORTHY LUTS-associated BPH is derived from a combination of immune activation, extracellular matrix remodeling, hyperplasia, and smooth muscle cell contraction in prostates of men. Using a mouse model, we describe the importance of mast cells in regulating these multiple facets involved in the pathophysiology of LUTS. Mast cell inhibition alleviates both pathology and Urinary Dysfunction in this model suggesting the potential for mast cell inhibition as a therapeutic that prevents and reverses pathology and associated symptomology.
