TME-Pelvic dissection Two phases Dorsal mobilisation Anterolateral dissection.
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TME-Pelvic dissection Two phases •Dorsal mobilisation •Anterolateral dissection
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Transcript of TME-Pelvic dissection Two phases Dorsal mobilisation Anterolateral dissection.
Below the aortic bifurcationPreserving superior hypogastric plexusPosterior dissectionPreserving left and right hypogastric nerveCutting rectosacral fascia (Waldeyer)
TME-Dorsal mobililsation
Bladder dysfunction:
Urinary retentionParasympathetic nerves - detrusor muscleSympathetic nerves - bladder neck, trigone and urethral area
Sexual dysfunction:
Impotence Parasympathetic nerves (nervi errigentes) - erectionSomatic nerves (pudendal n.) - penile rigidity
Ejaculatory dysfunctions Sympathetic nerves (from thoracolumbar region of spinal cord along the
sympathetic ganglia down hypogastric nerves to pelvic plexus)
Injuries to autonomic nerves in the pelvis