Sexual Dysfunction after Elective Endovascular or Hand-Assisted Laparoscopic Abdominal Aneurysm Repair

Veroux, Massimiliano; D’Arrigo, Giuseppe; Giaquinta, Alessia; Lomeo, Alberto

doi:10.1016/j.ejvs.2010.03.007

Cited by 16 publications

(24 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…) and abdominal aortic aneurysm replacements (Veroux et al. ). This unintended trauma could have widespread complications as the sympathetic nerves within the aortic plexus ultimately serve the spermatic plexus to the male gonads (Motoc et al.…”

Section: Discussionmentioning

confidence: 99%

“…It is worth noting that there are likely significant clinical implications in failing to appreciate that the aortic plexus is derived of bilaterally symmetrical cords, and that significant nerves, as well as the newly characterized prehypogastric ganglion, exist within the right cord on the caval side of the aorta. In fact, an incomplete understanding of the organization of the aortic plexus and its extensions into the pelvis may have predisposed these fine structures to the unintended damage during abdominal surgeries, such as retroperitoneal lymph node dissections for testicular cancer (Jewett & Groll, 2007;Heidenreich & Pfister, 2012;Hsiao et al 2012), anterior approach lumbar fusion surgeries (Lu et al 2009) and abdominal aortic aneurysm replacements (Veroux et al 2010). This unintended trauma could have widespread complications as the sympathetic nerves within the aortic plexus ultimately serve the spermatic plexus to the male gonads (Motoc et al 2010), the inferior mesenteric plexus to the hindgut, and the superior hypogastric plexus to the pelvic urogenital viscera (J€ anig & McLachlan, 1987;Giuliano & Cl ement, 2005).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Anatomy of the nerves and ganglia of the aortic plexus in males

et al. 2014

View full text Add to dashboard Cite

It is well accepted that the aortic plexus is a network of pre-and post-ganglionic nerves overlying the abdominal aorta, which is primarily involved with the sympathetic innervation to the mesenteric, pelvic and urogenital organs. Because a comprehensive anatomical description of the aortic plexus and its connections with adjacent plexuses are lacking, these delicate structures are prone to unintended damage during abdominal surgeries. Through dissection of fresh, frozen human cadavers (n = 7), the present study aimed to provide the first complete mapping of the nerves and ganglia of the aortic plexus in males. Using standard histochemical procedures, ganglia of the aortic plexus were verified through microscopic analysis using haematoxylin & eosin (H&E) and anti-tyrosine hydroxylase stains. All specimens exhibited four distinct sympathetic ganglia within the aortic plexus: the right and left spermatic ganglia, the inferior mesenteric ganglion and one previously unidentified ganglion, which has been named the prehypogastric ganglion by the authors. The spermatic ganglia were consistently supplied by the L1 lumbar splanchnic nerves and the inferior mesenteric ganglion and the newly characterized prehypogastric ganglion were supplied by the left and right L2 lumbar splanchnic nerves, respectively. Additionally, our examination revealed the aortic plexus does have potential for variation, primarily in the possibility of exhibiting accessory splanchnic nerves. Clinically, our results could have significant implications for preserving fertility in men as well as sympathetic function to the hindgut and pelvis during retroperitoneal surgeries.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Anatomy of the nerves and ganglia of the aortic plexus in males

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Of the laparoscopic-assisted infra-renal aneurysms, Veroux et al, 13 Alimi et al 18 and Ferrari et al 20 followed up patients for 12, 17 and 38 months, respectively. None of the groups reported aneurysm-related mortality or reinterventions.…”

Section: Long-term Follow-upmentioning

confidence: 99%

Systematic review of perioperative outcomes following laparoscopic abdominal aortic aneurysm repair

Rouhani¹,

Thapar

Maruthappu

et al. 2014

Vascular

View full text Add to dashboard Cite

show abstract

“…The aortic plexus is a complex network of sympathetic nerves overlying the infrarenal abdominal aorta containing significant innervation to the hindgut and pelvic organs. In males, disruption of the aortic plexus during retroperitoneal surgery is commonly associated with loss of antegrade ejaculation, and thus fertility (Flynn & Price, 1984;Jewett et al 1988;Jewett & Groll, 2007;Katz & Eggener, 2009;Veroux et al 2010;Heidenreich & Pfister, 2012;Hsiao et al 2012). Although nerve-sparing surgical procedures are currently recommended, the normal anatomy of the aortic plexus and its ganglia have not been described in significant detail.…”

Section: Introductionmentioning

confidence: 99%

Histological verification of the prehypogastric and ovarian ganglia confirms a bilaterally symmetrical organization of the ganglia comprising the aortic plexus in female human cadavers

et al. 2016

View full text Add to dashboard Cite

The aortic plexus is a network of sympathetic nerves positioned along the infrarenal abdominal aorta. Recently, we characterized the aortic plexus and its ganglia (inferior mesenteric, left/right spermatic, and prehypogastric ganglion) in males; however, the literature minimally describes its anatomy in females. In the present study, we conducted the first histological examination of the left and right ovarian ganglia, while also investigating whether females, like males, exhibit a prehypogastric ganglion. The ganglia were dissected from embalmed (n = 32) and fresh (n = 1) human cadavers, and H&E staining was used to confirm the presence of a left ovarian ganglion in 31/31 specimens, a right ovarian ganglion in 29/29 specimens and a prehypogastric ganglion in 25/28 specimens. Comparable to the topographic arrangement in males, there is a bilateral organization of the ganglia comprising the aortic plexus in females. More specifically, the left and right ovarian ganglia were positioned in close relation to their respective ovarian artery, whereas the prehypogastric ganglion was positioned within the right cord of the aortic plexus, contralateral to the inferior mesenteric ganglion. Using immunohistochemistry, it was shown that all ganglia from the fresh cadaver stained positive for tyrosine hydroxylase, thereby confirming their sympathetic nature. Having provided the first topographical and histological characterization of the ovarian and prehypogastric ganglia in females, future studies should seek to determine their specific function.

show abstract

Sexual Dysfunction after Elective Endovascular or Hand-Assisted Laparoscopic Abdominal Aneurysm Repair

Abstract: The HALS technique could be a minimally invasive alternative for sexually active males unsuitable for EVAR repair.

Cited by 16 publications

References 17 publications

Anatomy of the nerves and ganglia of the aortic plexus in males

Anatomy of the nerves and ganglia of the aortic plexus in males

Systematic review of perioperative outcomes following laparoscopic abdominal aortic aneurysm repair

Histological verification of the prehypogastric and ovarian ganglia confirms a bilaterally symmetrical organization of the ganglia comprising the aortic plexus in female human cadavers

Contact Info

Product

Resources

About