Sympathectomy, lumbar

An isolated case report describes a patient who had undergone bilateral lumbar sympathectomy who developed total urinary incontinence when taking methyldopa and phenoxybenzamine. 

A woman who had previously had bilateral lumbar sympathectomy for Raynaud s disease developed total urinary ineontinence when given methyldopa 500 mg to 1.5 g with phenoxybenzamine 12.5 mg daily, but not when she was taking either drug alone. This would seem to be the outcome... 

Pain caused by cancer of the pelvic viscera, and severe persistent tenesmus. All nociceptive pathways from the uterus and cervix pass through the lumbar sympathetic chain. In cases where persistent pain caused by cancer limited to the uterus is not amenable to the other forms of treatment, bilateral sympathectomy can be considered (Bonica 1990a,b). Block of the superior hypogastric plexus has been advocated as... 

In lumbar sympathectomy, complications that can occur include inadvertent injection of ethanol into vessels, vertebral disks, vertebral canal, ureters, and other adjacent organs. The other major complication of chemical lumbar sympathectomy is genitofemoral neuralgia. This is caused by the diffusion of ethanol to the genitofemoral nerve as it lies on the anterior surface of the psoas muscle. These complications have been described with conventional radiologic control, but can be prevented by proper technique and precise step-by-step CT control (Kurdziel and Dondelinger 1990). 

Stellate ganglion block, Lumbar sympathectomy. Peripheral nerve block... 

Xanthinol nicotinate (II), which combines representatives of two classes of vasodilators, namely xanthines and nicotinic acid analogs, has been used to improve circulation in a number of clinical and experimental studies. Placental insufficiency, resulting from low placental circulation, was significantly improved in 13 women who received this drug. Xanthinol also improved considerably lower limb circulation in 39 of 41 patients suffering from peripheral vascular disease and who had previously had lumbar sympathectomy. This work S implies that surgical interruption of the lumbar sympathetic pathways did not totally remove vasoconstrictor tone and that xanthinol was able to decrease or abolish the remaining vasoconstriction. 

Persson AV, Anderson L, Rodberg FT Jr. Selection of patients for lumbar sympathectomy. Surg Clin North Am 1985 65 393-403. 

Haimovici H, Steinman C, Karson IH. Evaluation of lumbar sympathectomy Advanced occlusive arterial disease. Arch Surg 1964 89 1089-1095. 

Szilagyi DE, Smith RE, Scarpella JR, et al. Lumbar sympathectomy Current role in the treatment of arteriosclerotic occlusive disease. Arc/i Surg 1967 95 753-761. 

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