A TEST FOR THE IDENTIFICATION OF RELEVANT SYMPATHETIC-NERVE FIBERS DURING NERVE SPARING RETROPERITONEAL LYMPHADENECTOMY

被引:21
作者
DIECKMANN, KP
HULAND, H
GROSS, AJ
机构
[1] Urologische Klinik, Klinikum Steglitz Frete Universitat, Berlin
关键词
TESTICULAR NEOPLASMS; LYMPH NODE EXCISION; NERVE FIBERS; SYMPATHETIC NERVOUS SYSTEM;
D O I
10.1016/S0022-5347(17)36935-5
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
We present a new intraoperative test for the identification of sympathetic nerve fibers relevant to ejaculation during nerve sparing retroperitoneal lymphadenectomy in patients with nonseminomatous testicular tumors. Electrostimulation of specific isolated postganglionic nerve fibers resulted in intraoperative ejaculation in 9 of 11 patients. Ejaculation was without tumescence in a noneruptive manner and was reproducible in most cases upon repeated stimulation. In 6 patients ejaculation resulted after stimulation of the L3 fiber and in 1 each after stimulation of the Ll, L2 and hypogastric plexus. The test seems to be particularly useful in post-chemotherapeutic dissections or otherwise extended dissections when sparing of irrelevant fibers is to be avoided.
引用
收藏
页码:1450 / 1452
页数:3
相关论文
共 14 条
[1]  
BAUMGARTEN HG, 1982, CONTR ONCOL, V8, P277
[2]   SACRAL ANTERIOR ROOT STIMULATORS FOR BLADDER CONTROL IN PARAPLEGIA - THE 1ST 50 CASES [J].
BRINDLEY, GS ;
POLKEY, CE ;
RUSHTON, DN ;
CARDOZO, L .
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 1986, 49 (10) :1104-1114
[3]   NERVE-PRESERVING BILATERAL RETROPERITONEAL LYMPHADENECTOMY - ANATOMICAL STUDY AND OPERATIVE APPROACH [J].
COLLESELLI, K ;
POISEL, S ;
SCHACHTNER, W ;
BARTSCH, G ;
DONOHUE, JP ;
RICHIE, JP .
JOURNAL OF UROLOGY, 1990, 144 (02) :293-298
[4]   DISTRIBUTION OF NODAL METASTASES IN NONSEMINOMATOUS TESTIS CANCER [J].
DONOHUE, JP ;
ZACHARY, JM ;
MAYNARD, BR .
JOURNAL OF UROLOGY, 1982, 128 (02) :315-320
[5]   NERVE-SPARING RETROPERITONEAL LYMPHADENECTOMY WITH PRESERVATION OF EJACULATION [J].
DONOHUE, JP ;
FOSTER, RS ;
ROWLAND, RG ;
BIHRLE, R ;
JONES, J ;
GEIER, G ;
JEWETT, MAS .
JOURNAL OF UROLOGY, 1990, 144 (02) :287-292
[6]   COMPLICATIONS OF RETROPERITONEAL LYMPH-NODE DISSECTION [J].
DONOHUE, JP ;
ROWLAND, RG .
JOURNAL OF UROLOGY, 1981, 125 (03) :338-340
[7]   RETROPERITONEAL LYMPHADENECTOMY FOR TESTIS TUMOR WITH NERVE SPARING FOR EJACULATION [J].
JEWETT, MAS ;
KONG, YSP ;
GOLDBERG, SD ;
STURGEON, JFG ;
THOMAS, GM ;
ALISON, RE ;
GOSPODAROWICZ, MK .
JOURNAL OF UROLOGY, 1988, 139 (06) :1220-1224
[8]   LUMBOSACRAL SYMPATHETIC TRUNK AS A COMPENSATORY PATHWAY FOR SEMINAL EMISSION AFTER BILATERAL HYPOGASTRIC NERVE TRANSECTIONS IN THE DOG [J].
KIHARA, K ;
SATO, K ;
ANDO, M ;
SATO, T ;
OSHIMA, H .
JOURNAL OF UROLOGY, 1991, 145 (03) :640-643
[9]  
RAY B, 1974, CANCER, V33, P340, DOI 10.1002/1097-0142(197402)33:2<340::AID-CNCR2820330207>3.0.CO
[10]  
2-Y