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Session: ePoster: Pelvic Floor 2 (Mon115)

EP811 - The role of Neuropelveology in the management of coloproctology patients

Monday, May 12, 2025
1:53 PM – 1:58 PM PT
All of the relevant financial relationships listed below have been mitigated.
Lara Burlamaqui Veras: This individual has no financial relationships with ineligible companies.
Carolina Vannucci Vasconcellos: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background:

Introduction: Neuropelveology, a field that encompasses the study of pelvic innervation and integrates the specialties of urology, gynecology, and coloproctology, has become essential in the management of pelvic disorders. Coloproctology patients often face debilitating conditions with various etiologies. Traditionally, treatments for these conditions have been symptomatic, with limited outcomes. However, advancements in Neuropelveology have significantly improved the ability to diagnose and treat neurological pelvic dysfunctions.

Objectives: To highlight the relevance of Neuropelveology in the treatment of pelvic floor disorders in coloproctology patients.

Methods/Interventions:

Method: A literature review was conducted using the PUBMED, BVS, and Scielo databases, with the descriptors "Neuropelveology," "Coloproctology," and "Pelvic Floor Dysfunction," along with terms such as "Treatment" and "Diagnosis."

Results/Outcomes:

Results: A total of 317 articles were identified, of which 11 met the inclusion criteria (published in the last 10 years, available in Portuguese or English, and full-text access). In coloproctology, the proper functioning of the sphincter and pelvic floor muscles, as well as the structures of the anal canal, rectum, sigmoid colon, and left colon, depends on innervation from the sacral roots S2, S3, and S4, via the pudendal and pelvic splanchnic nerves. Dysfunctions of the posterior pelvic compartment generally result from alterations in this innervation, which can be investigated by functional and anatomical exams, such as anorectal manometry, three-dimensional dynamic endoanal ultrasonography, and pelvic magnetic resonance imaging. The causes include nerve compression, vascular entrapment, iatrogenic injuries, and endometriosis. Treatment varies according to diagnosis, ranging from local botulinum toxin application, neuromodulation, to minimally invasive laparoscopic or robotic surgery for nerve decompression.

Conclusion/Discussion:

Conclusion: A detailed understanding of pelvic innervation is essential for the adequate management of pelvic floor dysfunctions. Focusing solely on the dysfunctional organ may not be effective, as its function is maintained by its innervation. Further studies and research are needed to improve diagnostic and therapeutic approaches in neuropelveology within coloproctology.