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Related Experiment Videos

Anorectal continence and bladder function. Effects of major sacral resection.

F Andreoli, F Balloni, A Bigiotti

    Diseases of the Colon and Rectum
    |October 1, 1986
    PubMed
    Summary

    Preserving one S-2 nerve root is crucial for maintaining anorectal continence and bladder function after sacral resection for chordoma. Bilateral S-2 loss leads to incontinence and impaired sensation.

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    Area of Science:

    • Neurology
    • Surgical Oncology
    • Urology

    Background:

    • Chordomas are rare bone tumors often requiring extensive surgical resection, potentially impacting sacral nerve roots.
    • Sacral nerve roots, particularly S-2, play a vital role in controlling anorectal and bladder functions.
    • Assessing the functional consequences of sacral nerve root resection is critical for patient outcomes.

    Observation:

    • Two patients undergoing sacral resection up to S-2 for chordomas were evaluated.
    • One patient had unilateral S-2 root division; the other had bilateral S-2 root division.
    • Functional assessments included anal manometry, sphincter electromyography, sensory testing (tactile, thermal, pain), and vesical manometry.

    Findings:

    • The patient with unilateral S-2 loss maintained perfect anorectal continence and discrimination of rectal contents.

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  • The patient with bilateral S-2 loss experienced incontinence and an inability to differentiate rectal contents.
  • Preservation of a single S-2 nerve root was sufficient for maintaining physiological anorectal continence and bladder function.

    • Implications:

    • Surgical strategies for sacral chordomas should aim to preserve at least one S-2 nerve root whenever possible.
    • Understanding the functional significance of individual sacral roots can guide surgical planning and patient counseling.
    • This finding highlights the critical role of the S-2 nerve root in sensory and motor control of the lower urinary tract and anorectum.