title: Bowel and bladder dysfunction following surgery within the presacral space: an overview of neuroanatomy, function, and dysfunction.
abstract: OBJECTIVE
  The presacral space contains a dense and complex network of nerves that have significant effects on the innervation of the pelvic viscera and support structures. The proximity of this space to the bony promontory of the sacrum has lead to its involvement in an array of corrective surgical procedures for pelvic floor disorders including sacrocolpopexy and rectopexy. Other procedures involving the same space include presacral neurectomy which involves intentional transection of the contained neural plexus to relieve refractory pelvic pain and resection of retrorectal or presacral tumors. Potential complications of these procedures are postoperative constipation and voiding dysfunction.
  
  
  METHODS
  Our aim was to review the current published literature on outcomes following a variety of procedures involving the presacral space and review postoperative bowel and urinary function. We also include an overview of the functional and structural anatomy of the presacral space and its corresponding neural plexi.
  
  
  CONCLUSIONS
  We conclude that quality data are lacking on the short-term and long-term rates for bowel and bladder dysfunction following surgical procedures involving the presacral space.
authors.affiliation: Department of Gynecology and Obstetrics, Emory University School of Medicine, 1639 Pierce Drive, Room 4305, Atlanta, GA, 30322, USA.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Huber
authors.forename: Gina M
authors.initials: GM
authors.lastname: Northington
authors.forename: Deborah R
authors.initials: DR
authors.lastname: Karp
mesh_terms: D004210:Dissection / Q000009:adverse effects; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D010388:Pelvis / Q000294:innervation*; D011183:Postoperative Complications / Q000209:etiology*; D012002:Rectal Diseases / Q000209:etiology*; D001750:Urinary Bladder, Neurogenic / Q000209:etiology*