| Project/Area Number |
63570751
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| Research Category |
Grant-in-Aid for General Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Research Field |
Urology
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| Research Institution | Saga Medical School |
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Principal Investigator |
KOMINE Shinichiro Saga Medical School, Department of Surgery, Instructor, 医学部, 講師 (00162058)
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| Co-Investigator(Kenkyū-buntansha) |
SUGIMORI Hajime Saga Medical School, Department of Obstetrics and Gynecology, Professor, 医学部, 教授 (50038642)
MASAKI Zenjiro Saga Medical School, Department of Surgery, Professor, 医学部, 教授 (40038716)
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| Project Period (FY) |
1988 – 1990
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| Project Status |
Completed (Fiscal Year 1990)
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| Budget Amount *help |
¥1,600,000 (Direct Cost: ¥1,600,000)
Fiscal Year 1990: ¥300,000 (Direct Cost: ¥300,000)
Fiscal Year 1989: ¥500,000 (Direct Cost: ¥500,000)
Fiscal Year 1988: ¥800,000 (Direct Cost: ¥800,000)
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| Keywords | Uterine cancer / Radical hysterectomy / Neurogenic bladder / Prevention / Nerve electrical stimulation / Pelvic plexus / Nerve identification / Voiding dysfunction / 神経温存 / 広汎性子宮全摘出 / 合併症 |
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| Research Abstract |
To prevent neurogenic bladder dysfunction following radical hysterectomy, nerve fibers branching off from the pelvic plexus were identified using electrical stimulation and preserved during operation. Nineteen female patients with uterine cancer were subjected to the study. Nerve fibers in the posterior side of the cardinal ligament were stimulated by a square wave with 5-19 volt and frequency of 20-50 cycle per second for 1-10 msec. During stimulation bladder pressure was monitored by a microchip catheter transducer. When an increase in bladder pressure was obtained by electrical stimulation, the stimulated nerve fibers were thought to be from the pelvic plexus and were preserved carefully. Thirty-eight bladder contractions in 13 patients were observed by electrical stimulation and their average increase in the pressure were 15 cm of water. In 3 patients in whom sphincteric urethral pressure was monitored simultaneously by a 3-way catheter, bladder contraction evoked by electrical stimulation accompanied a significant decrease in urethral pressure. The pelvic nerves innervating the bladder could be identified in 13 patients and the nerve fibers were preserved in 10 of 13. In 6 patients bladder pressure was not elevated by electrical stimulation and the pelvic nerve could not be detected. Of 10 patients in whom the pelvic nerve innervating the bladder was identified and preserved 4 had neurogenic bladder dysfunction postoperatively, while of 9 patients whose pelvic nerve could not be either detected or preserved 8 had neurogenic bladder dysfunction. We concluded that electrical stimulation during operation seems to be useful to identify the pelvic nerves innervating the bladder and to prevent neurogenic bladder dysfunction after radical hysterectomy.
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