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Pelvic floor injury

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https://www.readbyqxmd.com/read/28635237/-comparison-of-the-short-term-and-long-term-outcomes-of-laparoscopic-surgery-and-open-surgery-for-early-stage-cervical-cancer
#1
H Y He, Z J Yang, D Y Zeng, D S Yao, J T Fan, R F Zhao, J Q Zhang, X X Hu, Z Lin, Y M Jiang, L Li
Objective: To evaluate the short-term and long-term outcomes after laparoscopic surgery compared with traditional laparotomy in cases of stage ⅠA2-ⅡA2 cervical cancer. Methods: We conducted a retrospective study on the clinical data of 1 863 patients diagnosed as FIGO stages ⅠA2-ⅡA2 cervical cancer in 6 third-grade class-A hospitals in Guangxi province between January 2007 and May 2014. One thousand and seventy-one received laparoscopy, and 792 received laparotomy. T-test, U-test and χ(2) test were used to compare the short-term and long-term outcomes...
June 23, 2017: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/28629562/3t-mr-defecography-a-feasibility-study-in-sensorimotor-complete-spinal-cord-injured-patients-with-neurogenic-bowel-dysfunction
#2
Cornelia Putz, Celine D Alt, Cornelia Hensel, Björn Wagner, Simone Gantz, Hans-Jürgen Gerner, Norbert Weidner, Lars Grenacher
INTRODUCTION: To investigate whether MR-defecography can be employed in sensorimotor complete spinal cord injury (SCI) subjects as a potential diagnostic tool to detect defecational disorders associated with neurogenic bowel dysfunction (NBD) using standard parameters for obstructed defecation. MATERIAL AND METHODS: In a prospective single centre clinical trial, we developed MR-defecography in traumatic sensorimotor complete paraplegic SCI patients with upper motoneuron type injury (neurological level of injury T1 to T10) using a conventional 3T scanner...
June 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28616110/pelvic-organ-prolapse-a-primer-for-urologists
#3
REVIEW
Michel Bureau, Kevin V Carlson
Pelvic organ prolapse (POP) results from weakness or injury of the pelvic floor supports with resulting descent of one or more vaginal compartments (anterior, apical and/or posterior). Women typically become symptomatic from the bulging vaginal wall or related organ dysfunction once this descent reaches the introitus. POP is a common condition, affecting more than half of adult women. Many women presenting to an urologist for stress urinary incontinence or overactive bladder will have associated POP; therefore, it is important for urologists who treat these conditions to be familiar with its diagnosis and management...
June 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28609701/the-3d-pelvic-inclination-correction-system-pics-a-universally-applicable-coordinate-system-for-isovolumetric-imaging-measurements-tested-in-women-with-pelvic-organ-prolapse-pop
#4
Caecilia S Reiner, Tom Williamson, Thomas Winklehner, Sean Lisse, Daniel Fink, John O L DeLancey, Cornelia Betschart
In pelvic organ prolapse (POP), the organs are pushed downward along the lines of gravity, so measurements along this longitudinal body axis are desirable. We propose a universally applicable 3D coordinate system that corrects for changes in pelvic inclination and that allows the localization of any point in the pelvis at rest or under dynamic conditions on magnetic resonance images (MRI) of pelvic floor disorders in a scanner- and software independent manner. The proposed 3D coordinate system called 3D Pelvic Inclination Correction System (PICS) is constructed utilizing four bony landmark points, with the origin set at the inferior pubic point, and three additional points at the sacrum (sacrococcygeal joint) and both ischial spines, which are clearly visible on MRI images...
June 3, 2017: Computerized Medical Imaging and Graphics: the Official Journal of the Computerized Medical Imaging Society
https://www.readbyqxmd.com/read/28537946/gastrointestinal-manifestations-of-pelvic-floor-disorders-in-adolescents-a-diagnostic-framework-for-the-general-practitioner
#5
Anita Kochikar Pai, Sonia Arora Ballal
PURPOSE OF REVIEW: Pelvic floor disorders (PFDs) can present with gastrointestinal complaints in the adolescent patient, and identification of PFDs is aided by clues in the history and physical examination apparent to the knowledgeable clinician. The aim of this article is to provide a framework for the diagnostic evaluation of the adolescent patient with a PFD and introduce management strategies. RECENT FINDINGS: Patients with PFDs can present with gastrointestinal symptoms, including abdominal pain, constipation, incomplete evacuation, and fecal incontinence or nongastrointestinal complaints around genitourinary symptoms or sexual health...
May 19, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28523401/functional-and-quality-of-life-outcomes-following-obstetric-anal-sphincter-injury-oasi-does-the-grade-of-injury-affect-outcomes
#6
Lisa Ramage, Clarence Yen, Shengyang Qiu, Constantinos Simillis, Christos Kontovounisios, Paris Tekkis, Emile Tan
INTRODUCTION AND HYPOTHESIS: The aim of this study was to compare functional and quality of life data in patients with increasing grades of obstetric anal sphincter injury (OASI) presenting to a tertiary colorectal pelvic floor clinic within 24 months of delivery. METHODS: Prospective data were collected from the patients for the period 2009-2016 and included data on functional outcomes and motor anorectal manometry parameters. The instruments used for the evaluation of functional outcomes were the Birmingham Bowel and Urinary Symptoms Questionnaire, the Wexner Incontinence Score, Short Form 36, and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire...
May 18, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28391147/influence-of-a-pelvic-floor-training-programme-to-prevent-perineal-trauma-a-quasi-randomised-controlled-trial
#7
Fatima Leon-Larios, Isabel Corrales-Gutierrez, Rosa Casado-Mejía, Carmen Suarez-Serrano
BACKGROUND: perineal injury is common after birth and may be caused by tears or episiotomy or both. Perineal massage has been shown to prevent episiotomies in primiparous women. On the other hand, pelvic floor exercises might have an influence by shortening the first and second stages of labour in the primigravida. AIM: the aim of this study was to investigate the effects of a pelvic floor training following a birth programme on perineal trauma. DESIGN: a single-blind quasi-randomized controlled trial with two groups: standard care and intervention...
July 2017: Midwifery
https://www.readbyqxmd.com/read/28374792/cell-based-secondary-prevention-of-childbirth-induced-pelvic-floor-trauma
#8
REVIEW
Geertje Callewaert, Marina Monteiro Carvalho Mori Da Cunha, Nikhil Sindhwani, Maurilio Sampaolesi, Maarten Albersen, Jan Deprest
With advancing population age, pelvic-floor dysfunction (PFD) will affect an increasing number of women. Many of these women wish to maintain active lifestyles, indicating an urgent need for effective strategies to treat or, preferably, prevent the occurrence of PFD. Childbirth and pregnancy have both long been recognized as crucial contributing factors in the pathophysiology of PFD. Vaginal delivery of a child is a serious traumatic event, causing anatomical and functional changes in the pelvic floor. Similar changes to those experienced during childbirth can be found in symptomatic women, often many years after delivery...
June 2017: Nature Reviews. Urology
https://www.readbyqxmd.com/read/28361513/surgical-outcomes-and-safety-of-robotic-sacrocolpopexy-in-women-with-apical-pelvic-organ-prolapse
#9
Hyun Hwan Sung, Kwang Jin Ko, Yoon Seok Suh, Gyu Ha Ryu, Kyu-Sung Lee
PURPOSE: This study aimed to investigate the surgical outcomes and safety of robotic sacrocolpopexy (RSC) in patients with uterine/vaginal vault prolapse. METHODS: Between January 2009 and June 2015, 16 women with apical prolapse underwent RSC. Pelvic organ prolapse quantification (POP-Q) examination was performed, and treatment success was defined as the presence of grade 0 or I apical prolapse upon POP-Q examination at the final follow-up. Pelvic floor distress inventory-short form 20 (PFDI-SF 20) was administered at every follow-up...
March 24, 2017: International Neurourology Journal
https://www.readbyqxmd.com/read/28323222/laparoscopic-nerve-preserving-sacropexy
#10
Alfredo Ercoli, Stefano Cosma, Francesca Riboni, Giuseppe Campagna, Paolo Petruzzelli, Daniela Surico, Saverio Danese, Giovanni Scambia, Chiara Benedetto
STUDY OBJECTIVE: to demonstrate our developed nerve preserving technique during laparoscopic sacropexy (LSP) for multicompartment pelvic organ prolapse. DESIGN: exemplificative case of our surgical procedure based on a multicentric experience consisting of more than 800 cases in 10 years without major intraoperative complications. Informed consent was taken from the subject, and the institutional review board approved this research. SETTING: public practice at Maggiore della Carità University Hospital, Novara; at Sant'Anna Hospital, City of Health and Science, University of Torino; at A...
March 17, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28267057/female-pelvic-floor-biomechanics-bridging-the-gap
#11
Deanna C Easley, Steven D Abramowitch, Pamela A Moalli
PURPOSE OF REVIEW: The pelvic floor is a complex assembly of connective tissues and striated muscles that simultaneously counteracts gravitational forces, inertial forces, and intra-abdominal pressures while maintaining the position of the pelvic organs. In 30% of women, injury or failure of the pelvic floor results in pelvic organ prolapse. Surgical treatments have high recurrence rates, due, in part, to a limited understanding of physiologic loading conditions. It is critical to apply biomechanics to help elucidate how altered loading conditions of the pelvis contribute to the development of pelvic organ prolapse and to define surgeries to restore normal support...
May 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28191790/safety-and-short-term-outcomes-of-a-new-truly-minimallyinvasive-mesh-less-and-dissection-less-anchoring-system-for-pelvic-organ-prolapse-apical-repair
#12
Adi Y Weintraub, Masha Ben Zvi, David Yohay, Joerg Neymeyer, Yonatan Reuven, Menahem Neuman, Alex Tsivian
OBJECTIVE: To evaluate the safety and short term outcomes of a new, truly minimallyinvasive, mesh-less and dissection-less anchoring system for pelvic floor apical repair. METHODS: A prospective study was conducted using the NeuGuide™ device system for pelvic floor apical repair. The primary effectiveness outcome was centro-apical pelvic floor prolapse by POP-Q after six months. The primary safety outcome was intra-operative, immediate (first 48 h) post-operative complications and adverse effects after six months...
January 27, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28117880/intrapartum-predictors-of-maternal-levator-ani-injury
#13
MULTICENTER STUDY
Jessica Caudwell-Hall, Ixora Kamisan Atan, Andrew Martin, Rodrigo Guzman Rojas, Susanne Langer, Kalai Shek, Hans P Dietz
INTRODUCTION: Damage to the pelvic floor during vaginal childbirth is common, and may take the form of levator avulsion or irreversible overdistension of the levator hiatus (microtrauma). Such trauma is a major risk factor for pelvic organ prolapse later in life. In this study we aimed to identify intrapartum risk factors for levator trauma. MATERIAL AND METHODS: This is a retrospective analysis of data obtained in two perinatal studies on primiparous women. Between 2005 and 2014, 1148 women carrying an uncomplicated singleton pregnancy in the late third trimester were seen for 4D pelvic floor ultrasound and an interview...
April 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28067746/increasing-age-is-a-risk-factor-for-decreased-postpartum-pelvic-floor-strength
#14
Lieschen H Quiroz, Stephanie D Pickett, Jennifer D Peck, Ghazaleh Rostaminia, Daniel E Stone, S Abbas Shobeiri
OBJECTIVES: This study aimed to determine factors associated with decreased pelvic floor strength (PFS) after the first vaginal delivery (VD) in a cohort of low-risk women. METHODS: This is a secondary analysis of a prospective study examining the risk of pelvic floor injury in a cohort of primiparous women. All recruited participants underwent an examination, three-dimensional ultrasound and measurement of PFS in the third trimester and repeated at 4 weeks to 6 months postpartum using a perineometer...
March 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28035441/continuous-recording-of-intrarectal-pressures-during-the-second-phase-of-labour-correlations-with-postpartum-pelvic-floor-complaints-a-biomechanical-clinical-study
#15
Sylvain Meyer, François Salchli, Patrick Hohlfeld, David Baud, Yvan Vial, Chahin Achtari
INTRODUCTION AND HYPOTHESIS: We correlated intrarectal pressure parameter recordings during the second phase of labour in primiparous women with postpartum pelvic floor (PF) complaints to try to define a critical pressure threshold for the occurrence of permanent PF injury. METHODS: Using a microsystem device, the duration of bearing-down efforts, the area under the pressure curve and the peak pressure during bearing-down efforts were continuously recorded in 43 women with spontaneous delivery (group one) and in 17 women with forceps-assisted delivery (group two)...
December 29, 2016: International Urogynecology Journal
https://www.readbyqxmd.com/read/28027607/third-or-fourth-degree-intrapartum-anal-sphincter-tears-are-associated-with-levator-ani-avulsion-in-primiparas
#16
Dan V Valsky, Sarah M Cohen, Michal Lipschuetz, Drorith Hochner-Celnikier, Hagit Daum, Itai Yagel, Simcha Yagel
OBJECTIVES: We evaluated primiparous women with clinically diagnosed third- and fourth-degree and anal sphincter tears, to evaluate the rate of levator ani muscle injury compared to primiparous women without sphincter tears. METHODS: Primiparous women delivering in our maternity ward with intrapartum diagnoses of third- or fourth-degree anal sphincter tears, repaired by the overlapping technique, were recruited to undergo 3-dimensional transperineal sonography of the pelvic floor anatomy, including the anterior and posterior compartments...
April 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28025682/impact-of-subsequent-birth-and-delivery-mode-for-women-with-previous-oasis-systematic-review-and-meta-analysis
#17
REVIEW
Sara S Webb, Derick Yates, Margarita Manresa, Matthew Parsons, Christine MacArthur, Khaled M K Ismail
INTRODUCTION AND HYPOTHESIS: Obstetric anal sphincter injuries (OASIS) are serious complications of vaginal birth. In a pregnancy following OASIS women may be keen to avoid an elective caesarean section, yet cautious about pursuing another vaginal birth that may result in further damage to the pelvic floor and possible long-term anal incontinence. This review aimed to evaluate the impact of subsequent birth and its mode on anal incontinence (AI) and/or quality of life (QoL), for women with previous OASIS...
April 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/27980522/ultrasound-imaging-in-urogynecology-state-of-the-art-2016
#18
Michał Bogusiewicz
The role of ultrasound imaging in urogynecology is not clearly defined. Despite significant developments in visualization techniques and interpretation of images, pelvic ultrasound is still more a tool for research than for clinical practice. Structures of the lower genitourinary tract and pelvic floor can be visualized from different approaches: transperineal, introital, transvaginal, abdominal or endoanal. According to contemporary guidelines and recommendations, the role of ultrasound in urogynecology is limited to the measurement of post-void residue...
November 2016: Przeglad Menopauzalny, Menopause Review
https://www.readbyqxmd.com/read/27939329/pelvic-floor-morphometry-and-function-in-women-with-and-without-puborectalis-avulsion-in-the-early-postpartum-period
#19
COMPARATIVE STUDY
Marie-Pierre Cyr, Jennifer Kruger, Vivien Wong, Chantale Dumoulin, Isabelle Girard, Mélanie Morin
BACKGROUND: Pelvic floor muscles are subject to considerable stretching during vaginal birth. In 13-36% of women, stretching results in avulsion injury whereby the puborectalis muscle disconnects from its insertion points on the pubis bone. Until now, few studies have investigated the effect of this lesion on pelvic floor muscles in the early postpartum period. OBJECTIVE: The primary aim of this study was to compare pelvic floor muscle morphometry and function in primiparous women with and without puborectalis avulsion in the early postpartum period...
March 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27872979/evaluation-of-isolated-urinary-stress-incontinence-according-to-the-type-of-levator-ani-muscle-lesion-using-3-4d-transperineal-ultrasound-36%C3%A2-months-post-partum
#20
José Antonio García Mejido, Pamela Valdivieso Mejias, Ana Fernández Palacín, María José Bonomi Barby, Paloma De la Fuente Vaquero, José Antonio Sainz Bueno
INTRODUCTION: Vaginal delivery can lead to pelvic floor disorders. Many authors have described pelvic floor injuries that can predict future defects such as urinary incontinence and pelvic organ prolapse. We propose the assessment of urinary stress incontinence and its association with levator ani muscle (LAM) microtrauma (>20% in the levator hiatus area during Valsalva) and macrotraumas (avulsion) identified by 3/4D transperineal ultrasound (3D-TpUS) 36 months post-partum. MATERIALS AND METHODS: This was a prospective observational study including 168 nulliparous women...
July 2017: International Urogynecology Journal
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