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Pelvic floor injury

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https://www.readbyqxmd.com/read/29117653/effect-of-delivery-and-episiotomy-on-the-emergence-of-urinary-incontinence-in-women-review-of-literature
#1
Krešimir Živković, Nikica Živković, Tomislav Župić, Damir Hodžić, Vjekoslav Mandić, Slavko Orešković
Episiotomy is obstetric procedure during which the incision extends the vestibule of the vagina during the second stage of labor. Episiotomy was extensively spread with gradual increase of rates in the first half of the 20th century and was performed medio-laterally in all nulliparous women with the idea to protect fetal head from trauma and pelvic floor from injuries. However, reports claiming that episiotomy had no such benefits were published. It was shown that routine medio-lateral episiotomy did not protect against the appearance of urinary incontinence after vaginal delivery, while the risk of anal incontinence could be increased...
December 2016: Acta Clinica Croatica
https://www.readbyqxmd.com/read/29117015/racial-ethnic-differences-in-perineal-lacerations-in-a-diverse-urban-healthcare-system
#2
Amanda Williams, Beverly Gonzalez, Colleen Fitzgerald, Cynthia Brincat
OBJECTIVES: The aim of the study was o determine whether variations exist between races/ethnicities in perineal laceration at first vaginal delivery. METHODS: We assessed first vaginal deliveries greater than 35 weeks gestation, for a four-year period, in our diverse urban healthcare system. Predictor variable was race/ethnicity with outcome variable of none, first-, second-, third-, or fourth-degree perineal laceration. Race and ethnicity were self-reported and combined into one variable to facilitate analysis...
November 7, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29022787/does-a-missed-obstetric-anal-sphincter-injury-at-time-of-delivery-affect-short-term-functional-outcome
#3
L Ramage, C Yen, S Qiu, C Simillis, C Kontovounisios, E Tan, P Tekkis
Introduction This study aimed to ascertain whether missed obstetric anal sphincter injury at delivery had worse functional and quality of life outcomes than primary repair immediately following delivery. Materials and methods Two to one propensity matching was undertaken of patients presenting to a tertiary pelvic floor unit with ultrasound evidence of missed obstetric anal sphincter injury within 24 months of delivery with patients who underwent primary repair at the time of delivery by parity, grade of injury and time to assessment...
September 15, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28988909/detailed-muscular-structure-and-neural-control-anatomy-of%C3%A2-the-levator-ani-muscle-a-study-based-on-female-human%C3%A2-fetuses
#4
Krystel Nyangoh Timoh, David Moszkowicz, Mazen Zaitouna, Cedric Lebacle, Jelena Martinovic, Djibril Diallo, Maud Creze, Vincent Lavoue, Emile Darai, Gérard Benoit, Thomas Bessede
BACKGROUND: Injury to the levator ani muscle or pelvic nerves during pregnancy and vaginal delivery is responsible for pelvic floor dysfunction. OBJECTIVE: We sought to demonstrate the presence of smooth muscular cell areas within the levator ani muscle and describe their localization and innervation. STUDY DESIGN: Five female human fetuses were studied after approval from the French Biomedicine Agency. Specimens were serially sectioned and stained by Masson trichrome and immunostained for striated and smooth muscle, as well as for somatic, adrenergic, cholinergic, and nitriergic nerve fibers...
October 6, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28953075/comparing-3-dimensional-ultrasound-to-3-dimensional-magnetic-resonance-imaging-in-the-detection-of-levator-ani-defects
#5
Camille S Calderwood, Amy Thurmond, Amanda Holland, Blake Osmundsen, W Thomas Gregory
OBJECTIVE: The aim of this study was to compare the detection of levator ani defects (LAD) between 3-dimensional (3D) ultrasound (US) and 3D magnetic resonance imaging (MRI). METHODS: This is a secondary analysis of the Pelvic Floor Nerve Injury Following Childbirth Study. Nulliparous women underwent a standardized protocol of pelvic floor evaluations between January 2008 and December 2013, prior to pregnancy (V1) and at 2 points postpartum: 6 weeks (V2) and 6 months (V3)...
September 26, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28941806/contemporary-review-of-male-and-female-climacturia-and-urinary-leakage-during-sexual-activities
#6
REVIEW
Melissa H Mendez, Stephanie J Sexton, Aaron C Lentz
INTRODUCTION: Urinary leakage during sexual activity is a prevalent and often distressing condition that is under-addressed despite having a range of reasonable treatment options. AIM: To review the available literature on prevalence, pathophysiology, and treatment of urinary leakage during sexual activities. METHODS: A literature review was performed through PubMed from 1996 to 2017 regarding urinary leakage during sexual activities for men and women including foreplay incontinence, coital incontinence, and climacturia...
September 20, 2017: Sexual Medicine Reviews
https://www.readbyqxmd.com/read/28922462/vaginal-mesh-repair-systems-for-pelvic-organ-prolapse-anatomical-study-comparing-transobturator-trangluteal-versus-single-incision-techniques
#7
Giuseppe Campagna, Giovanni Panico, Andrea Morciano, Pierre Gadonneix, Vincent Delmas, Mauro Cervigni, Alfredo Ercoli, Giovanni Scambia
INTRODUCTION: The present study aim to compare the anatomic landmarks of two pelvic floor repair systems, in order to identify the potential neurovascular lesions related to different mesh fixation techniques. METHODS: Abdominal and perineal dissections of 10 fresh cadavers after prolapse surgery using transobturator/transgluteal versus single incision techniques. Neuro-vascular structures of obturator region and perineum were isolated. Distances between needles and anatomical structures were measured...
September 18, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28894152/combination-of-tomographic-ultrasound-imaging-and-three-dimensional-magnetic-resonance-imaging-based-model-to-diagnose-postpartum-levator-avulsion
#8
Yulin Yan, Chaoran Dou, Xia Wang, Yan Xi, Bing Hu, Li Ma, Tao Ying
Vaginal delivery may cause levator avulsion, which may increase the risk of pelvic floor dysfunction (PFD). To explore the morphological changes of the levator ani muscle (including the puborectalis and iliococcygeus) and levator avulsion after vaginal delivery, translabial tomographic ultrasound imaging (TUI) was used to examine 80 women 45-60 days after their vaginal delivery. Subsequently, magnetic resonance imaging (MRI) was performed if at least one-sided puborectalis avulsion was found on TUI. The incidence of puborectalis avulsion in these postpartum women was 13...
September 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28886617/viscous-effects-in-pelvic-floor-muscles-during-childbirth-a-numerical-study
#9
M C P Vila Pouca, J P S Ferreira, D A Oliveira, M P L Parente, R M Natal Jorge
During vaginal delivery women sustain stretching of their pelvic floor, risking tissue injury and adverse outcomes. Realistic numerical simulations of childbirth can help in the understanding of the pelvic floor mechanics and on the prevention of related disorders. In previous studies, biomechanical finite element simulations of a vaginal delivery have been performed disregarding the viscous effects present on all biological soft tissues. The inclusion of the viscoelastic behaviour is fundamental, since it allows to investigate rate-dependent responses...
September 8, 2017: International Journal for Numerical Methods in Biomedical Engineering
https://www.readbyqxmd.com/read/28838787/surgical-interventions-and-the-use-of-device-aided-therapy-for-the-treatment-of-fecal-incontinence-and-defecatory-disorders
#10
Adil E Bharucha, Satish S C Rao, Andrea S Shin
The purpose of this clinical practice update expert review is to describe the key principles in the use of surgical interventions and device-aided therapy for managing fecal incontinence (FI) and defecatory disorders. The best practices outlined in this review are based on relevant publications, including systematic reviews and expert opinion (when applicable). Best Practice Advice 1: A stepwise approach should be followed for management of FI. Conservative therapies (diet, fluids, techniques to improve evacuation, a bowel training program, management of diarrhea and constipation with diet and medications if necessary) will benefit approximately 25% of patients and should be tried first...
December 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28818731/association-between-severities-of-striae-gravidarum-and-obstetric-anal-sphincter-injuries-oasis
#11
Ofra Halperin, Anita Noble, Shosh Balachsan, Ester Klug, Michal Liebergall-Wischnitzer
OBJECTIVES: to examine the association between the severities of Striae Gravidarum (SG) and Obstetric Anal Sphincter Injuries (OASIS) and to measure the symptoms regarding urinary incontinence, fecal/flatus incontinence, and dyspareunia, at 6 and 12 months postpartum. DESIGN: this is a cohort study. SETTING: four university teaching medical centers in Israel, two in the north and two in the center of the country. PARTICIPANTS: women with OASIS were interviewed and assessed for SG...
November 2017: Midwifery
https://www.readbyqxmd.com/read/28801220/multiple-reflex-pathways-contribute-to-bladder-activation-by-intraurethral-stimulation-in-persons-with-spinal-cord-injury
#12
Meredith J McGee, Brandon D Swan, Zachary C Danziger, Cindy L Amundsen, Warren M Grill
OBJECTIVE: To measure the urodynamic effects of electrical co-stimulation of 2 individual sites in the proximal and distal urethra in persons with spinal cord injury (SCI). This work was motivated by preclinical findings that selective co-stimulation of the cranial urethral sensory nerve and the dorsal genital nerve, which innervate the proximal and distal portions of the urethra, respectively, increased reflex bladder activation and voiding efficiency. MATERIALS AND METHODS: Electrical co-stimulation of urethral afferents was conducted in persons with chronic SCI during urodynamics...
November 2017: Urology
https://www.readbyqxmd.com/read/28762694/pelvic-organ-prolapse
#13
REVIEW
Cheryl B Iglesia, Katelyn R Smithling
Pelvic organ prolapse is the descent of one or more of the anterior vaginal wall, posterior vaginal wall, the uterus (cervix), or the apex of the vagina (vaginal vault or cuff scar after hysterectomy). Prevalence increases with age. The cause of prolapse is multifactorial but is primarily associated with pregnancy and vaginal delivery, which lead to direct pelvic floor muscle and connective tissue injury. Hysterectomy, pelvic surgery, and conditions associated with sustained episodes of increased intra-abdominal pressure, including obesity, chronic cough, constipation, and repeated heavy lifting, also contribute to prolapse...
August 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28699402/the-management-of-episiotomy-technique-and-its-effect-on-pelvic-floor-muscles-during-a-malposition-childbirth
#14
Dulce A Oliveira, Marco P L Parente, Begoña Calvo, Teresa Mascarenhas, Renato M Natal Jorge
Vaginal childbirth is the leading cause of pelvic floor muscles injury, which contributes to pelvic floor dysfunction, being enhanced by fetal malposition. Therefore, the aim of the present study is to verify the influence of mediolateral episiotomies in the mechanics of the pelvic floor with the fetus in occiput posterior position when compared to the occiput anterior position. Numerical simulations of vaginal deliveries, with and without episiotomy, are performed based on the Finite Element Method. The biomechanical model includes the pelvic floor muscles, a surface to delimit the anterior region of the birth canal and a fetus...
August 2017: Computer Methods in Biomechanics and Biomedical Engineering
https://www.readbyqxmd.com/read/28681229/late-reconstruction-of-severe-open-book-deformities-of-the-pelvis-tips-and-tricks
#15
Christian Fang, Hatem Alabdulrahman, Roman Pfeifer, Ivan S Tarkin, Hans-Christoph Pape
BACKGROUND: The primary goal of treatment for open book pelvic injuries after high-energy trauma is to control haemorrhage and to close the pelvic ring anatomically. Less commonly, patients may present late with malunion or non-union. METHODS: We reviewed five operatively treated patients with delayed severe open book deformities who had a diastasis of more than 6 cm. We describe the pre-operative workup, surgical strategy and challenges experienced. They specifically include: extensive scar and contracture formation, malunion, urogenital prolapse and difficult reduction of vertical shear element...
September 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28664535/characterizing-levator-ani-muscle-stiffness-pre-and-post-childbirth-in-european-and-polynesian-women-in-new-zealand-a-pilot-study
#16
COMPARATIVE STUDY
Jennifer A Kruger, Stephanie C Budgett, Vivien Wong, Poul M F Nielsen, Martyn P Nash, Jackie Smalldridge, Lynsey M Hayward, Tania Y Tian, Andrew J Taberner
INTRODUCTION: The influence of levator-ani muscles on second-stage labor is poorly understood. The ability of these muscles to stretch without damage may affect birth outcomes, but little is known about material properties, effects of pregnancy and/or ethnicity on levator-ani stiffness. There are strong associations between muscle damage and subsequent pelvic floor disorders. This study aimed to quantify levator-ani muscle stiffness during the third trimester of pregnancy and postpartum in European and Polynesian women...
October 2017: Acta Obstetricia et Gynecologica Scandinavica
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
#17
COMPARATIVE STUDY
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
#18
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
#19
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
#20
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...
July 2017: Computerized Medical Imaging and Graphics: the Official Journal of the Computerized Medical Imaging Society
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