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Operative Technique
October 2004

A Simple Technique for Identification and Preservation of the Hypogastric Nerves During Rectal Surgery

Author Affiliations

From the Department of Surgery, Section of Colon and Rectal Surgery, University of Louisville, Ky (Drs Combs and Galandiuk); the Digestive Health Center, University of Louisville Hospital, Ky (Dr Galandiuk); and the Department of Surgery, Hospital of Camposampiero (Padova), Italy (Dr Morpurgo).

Arch Surg. 2004;139(10):1106-1109. doi:10.1001/archsurg.139.10.1106

Hypothesis  Rectal resection is associated with a risk of sexual dysfunction even when performed for benign disease, with the most frequent type resulting in retrograde ejaculation due to injury to the hypogastric nerves.

Design  A simple technique to identify and protect these nerves during rectal mobilization.

Setting  Exposure of the hypogastric plexus during rectal resection.

Conclusion  Careful identification of the hypogastric nerves during rectal mobilization using the described technique may reduce injury to these nerves and related sexual dysfunction.