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Pelvic floor injury

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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
#1
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...
November 21, 2016: International Urogynecology Journal
https://www.readbyqxmd.com/read/27780347/indications-and-complications-associated-with-the-removal-of-506-pieces-of-vaginal-mesh-used-in-pelvic-floor-reconstruction-a-multicenter-study
#2
John R Miklos, Orawee Chinthakanan, Robert D Moore, Deborah R Karp, Gladys M Nogueiras, G Willy Davila
STUDY OBJECTIVE: Synthetic mesh utilized to treat stress urinary incontinence (SUI) and pelvic organ prolapse (POP) can often result in postoperative complications. The objectives of this study were to determine: 1) the most common indications for mesh removal; 2) the incidences of the removal of specific mesh procedures (such as suburethral sling [SUS], transvaginal mesh [TVM], or sacrocolpopexy); and 3) the idences and types of surgical complications associated with mesh removal. DESIGN: This was a retrospective study...
October 26, 2016: Surgical Technology International
https://www.readbyqxmd.com/read/27778369/is-bladder-neck-and-urethral-mobility-associated-with-urinary-incontinence-and-mode-of-delivery-4-years-after-childbirth
#3
Ingrid Volløyhaug, Isabelle van Gruting, Kim van Delft, Abdul H Sultan, Ranee Thakar
AIMS: To study changes in bladder neck, urethral mobility and urinary incontinence (UI) from pregnancy to 4 years postpartum and demonstrate any association to mode of delivery or presence of levator ani muscle (LAM) injury. Secondly, we aimed to correlate bladder neck and urethral mobility to UI symptoms. METHODS: Prospective study of 180 women, recruited in their first pregnancy and followed up 1 and/or 4 years postpartum. UI symptoms were assessed with a validated questionnaire...
October 24, 2016: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/27614758/laparoscopic-fixation-of-the-vaginal-cuff-to-the-uterosacral-ligaments-at-the-time-of-hysterectomy
#4
Kazuaki Nishimura, Kazuaki Yoshimura, Kaori Hoshino, Toru Hachisuga
INTRODUCTION AND HYPOTHESIS: Transvaginal ipsilateral uterosacral ligament colpopexy for pelvic organ prolapse (POP), which was reported by Shull et al. (Shull's colpopexy) in 2000, is one of the most frequently performed non-mesh pelvic floor reconstructive surgical procedures. Despite its excellent anatomical outcomes, ureteral injury and difficulty in uterosacral ligament detection (especially in patients with severe POP) are typical issues with this procedure. METHOD: This video demonstrates the procedure in a 58-year-old woman, gravida 2 para 2, with POP-Q stage II uterine prolapse and stage I cystocele...
September 10, 2016: International Urogynecology Journal
https://www.readbyqxmd.com/read/27613623/residual-defects-after-repair-of-obstetric-anal-sphincter-injuries-and-pelvic-floor-muscle-strength-are-related-to-anal-incontinence-symptoms
#5
Cristina Ros Cerro, Eva Martínez Franco, Giulio Aniello Santoro, Maria José Palau, Pawel Wieczorek, Montserrat Espuña-Pons
INTRODUCTION AND HYPOTHESIS: The aim was to analyze the correlation between residual anal sphincter (AS) defects and pelvic floor muscle (PFM) strength on anal incontinence (AI) in patients with a history of obstetric AS injuries (OASIS). METHODS: From September 2012 to February 2015, an observational study was conducted on a cohort of females who underwent repair of OASIS intrapartum. The degree of OASIS was scored intrapartum according to Sultan's classification...
September 9, 2016: International Urogynecology Journal
https://www.readbyqxmd.com/read/27575633/perioperative-outcomes-for-laparotomy-compared-to-robotic-surgical-staging-of-endometrial-cancer-in-the-elderly-a-retrospective-cohort
#6
Floor J Backes, Adam C ElNaggar, Michael Ryan Farrell, Lorna A Brudie, Sarfraz Ahmad, Ritu Salani, David E Cohn, Robert W Holloway, Jeffrey M Fowler, David M O'Malley
OBJECTIVE: This study aimed to compare outcomes of endometrial cancer (EMCA) staging in elderly patients performed either robotically or via laparotomy. METHODS: A retrospective, multi-institutional chart review was conducted of all robotic and laparotomy staging surgeries for EMCA between 2003 and 2009. Charts were reviewed for intraoperative and postoperative complications and morbidities. RESULTS: Seven hundred forty-six women were identified who had undergone EMCA staging either robotically or via laparotomy; 89 and 93 patients 70 years or older underwent staging for EMCA via robotic and laparotomy, respectively...
August 29, 2016: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/27568414/do-maternal-pushing-techniques-during-labour-affect-obstetric-or-neonatal-outcomes
#7
C Barasinski, D Lemery, F Vendittelli
OBJECTIVES: To assess, through a literature review, the maternal and neonatal morbidity associated with the type of pushing used during the second stage of labour. METHODS: We searched the Cochrane Library and the Medline database for randomised controlled trials from 1980 to 2015, using the following keywords: "delivery", "birth", "birthing", "bearing down, coached, uncoached, pushing", "second and stage and labour", "randomised controlled trials" and "meta-analysis"...
August 24, 2016: Gynécologie, Obstétrique & Fertilité
https://www.readbyqxmd.com/read/27562467/finite-element-model-focused-on-stress-distribution-in-the-levator-ani-muscle-during-vaginal-delivery
#8
Ladislav Krofta, Linda Havelková, Iva Urbánková, Michal Krčmář, Luděk Hynčík, Jaroslav Feyereisl
INTRODUCTION AND HYPOTHESIS: During vaginal delivery, the levator ani muscle (LAM) undergoes severe deformation. This stress can lead to stretch-related LAM injuries. The objective of this study was to develop a sophisticated MRI-based model to simulate changes in the LAM during vaginal delivery. METHODS: A 3D finite element model of the female pelvic floor and fetal head was developed. The model geometry was based on MRI data from a nulliparous woman and 1-day-old neonate...
August 25, 2016: International Urogynecology Journal
https://www.readbyqxmd.com/read/27558763/modeling-the-second-stage-of-labor
#9
Xiani Yan, Jennifer A Kruger, Xinshan Li, Poul M F Nielsen, Martyn P Nash
Vaginal delivery is the primary cause of levator ani muscle injury, which is in turn the leading factor contributing to pelvic floor disorders including pelvic organ prolapse and urinary stress incontinence. Existing biomechanical models of childbirth have provided some understanding of pelvic floor function during delivery and have helped in the investigation of preventative strategies. The modeling frameworks for childbirth simulation are described with emphasis on (1) the recent advances in medical imaging quality and computational power; (2) improvements in the anatomical representation of the pelvic floor and fetal head; (3) more realistic boundary conditions for delivery; and (4) mechanical properties determined from experiments...
November 2016: Wiley Interdisciplinary Reviews. Systems Biology and Medicine
https://www.readbyqxmd.com/read/27557396/levator-ani-muscle-injuries-associated-with-vaginal-vacuum-assisted-delivery-determined-by-3-4d-transperineal-ultrasound
#10
J A Garcia-Mejido, Dra L Gutierrez, A Fernandez-Palacín, Dra A Aquise, J A Sainz
OBJECTIVES: To determine the rate of pelvic floor trauma, levator ani muscle (LAM) avulsion as well as the mean difference in levator hiatus area, after normal vaginal deliveries (NVD) and vacuum assisted deliveries (VD), assessed with three-dimensional transperineal ultrasound (3D-TpUS). MATERIALS AND METHODS: Prospective observational study with 151 nulliparous women with NVD or VD at ≥37 weeks between 9-2012 and 6-2013. 3D-TpUS was performed 6 months after every patient's delivery, during which LAM, anteroposterior diameter, transverse diameter and levator hiatus area were assessed...
August 24, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27557074/-incontinence-etiology-diagnostics-and-therapy
#11
Thomas Frieling
Fecal incontinence is defined by the unintentional loss of solid or liquid stool, and anal incontinence includes leakage of gas and / or fecal incontinence. Anal-fecal incontinence is not a diagnosis but a symptom. Many patients hide the problem from their families, friends, and even their doctors. Epidemiologic studies indicate a prevalence between 7-15 %, up to 30 % in hospitals and up to 70 % in longterm care settings. Anal-fecal incontinence causes a significant socio-economic burden. There is no widely accepted approach for classifying anal-fecal incontinence available...
August 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27517338/what-s-new-in-the-functional-anatomy-of-pelvic-organ-prolapse
#12
John O L DeLancey
PURPOSE OF REVIEW: Provide an evidence-based review of pelvic floor functional anatomy related to pelvic organ prolapse. RECENT FINDINGS: Pelvic organ support depends on interactions between the levator ani muscle and pelvic connective tissues. Muscle failure exposes the vaginal wall to a pressure differential producing abnormal tension on the attachments of the pelvic organs to the pelvic sidewall. Birth-induced injury to the pubococcygeal portion of the levator ani muscle is seen in 55% of women with prolapse and 16% of women with normal support...
October 2016: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27497647/factors-associated-with-timing-of-return-to-intercourse-after-obstetric-anal-sphincter-injuries
#13
Alix Leader-Cramer, Kimberly Kenton, Bhumy Davé, Dana R Gossett, Margaret Mueller, Christina Lewicky-Gaupp
INTRODUCTION: The impact of obstetric perineal trauma on timing of return to intercourse is unclear, although sexual desire is clearly decreased in these women. In addition, studies examining timing of return to intercourse are cross-sectional and therefore cannot delineate potential reasons that patients might delay return to intercourse. AIM: To identify factors associated with delayed return to intercourse after obstetric anal sphincter injuries. METHODS: This was a planned secondary analysis of a prospective cohort study of women sustaining obstetric anal sphincter injuries during delivery of a full-term singleton infant...
October 2016: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/27451064/evaluation-of-long-term-pelvic-floor-symptoms-after-an-obstetric-anal-sphincter-injury-oasi-at-least-one-year-after-delivery-a-retrospective-cohort-study-of-159-cases
#14
D Desseauve, S Proust, C Carlier-Guerin, C Rutten, F Pierre, X Fritel
OBJECTIVES: The aim of this study was to assess long-term pelvic floor symptoms after an obstetric anal sphincter injury (OASI). METHODS: This retrospective cohort study included 237 cases of OASI (0.86% of deliveries) identified at Poitiers University Hospital between 2000 and 2011. Symptoms were assessed using validated self-administered questionnaires, including Female Pelvic Floor Questionnaire, Pescatori anal incontinence score, EuroQoL five-dimension score, and pain visual analogue scale (VAS)...
July 2016: Gynécologie, Obstétrique & Fertilité
https://www.readbyqxmd.com/read/27450748/-assessment-of-severity-of-neurogenic-bowel-dysfunction-in-chronic-patients-with-a-simple-1-item-questionnaire-pgi-s
#15
J G Prévinaire, J M Soler, H Bordji, M C Fiolet, M A Navaux, P E Mortier
INTRODUCTION: Bowel symptoms (constipation and incontinence) are frequent in patients with a neurologic disease, but rarely assessed in rehabilitation centres. AIM: To study the prevalence of neurogenic bowel dysfunction (NBD) in those patients, and to assess its severity with the Patient Global Impression of Severity (PGI-S). MATERIAL: Prospective study by questionnaires, with the Neurogenic Bowel Dysfunction Score (0-47) and the PGI-S, a 1-item questionnaire (absent, mild, moderate, severe) for the severity of the bowel symptoms, and the Bristol Stool Chart for stool consistency...
September 2016: Progrès en Urologie
https://www.readbyqxmd.com/read/27438809/mesh-perforation-into-a-viscus-in-the-setting-of-pelvic-floor-surgery-presentation-and-management
#16
REVIEW
Seth A Cohen, Howard B Goldman
Perforation of a viscus with a mesh product either during or subsequent to pelvic floor reconstruction can be associated with devastating outcomes. If surgeons are going to place mesh, they also need to be familiar with symptoms concerning for perforation. The index of suspicion should always be present, as these patients can present years after initial mesh placement. The best opportunity for intervention in these serious complications is the first intervention. As bits of mesh are chipped away during attempted interventions, residual mesh fragments become disjointed, frayed, and scarred further, making their removal even more challenging, in addition to traumatizing likely already weakened tissues...
September 2016: Current Urology Reports
https://www.readbyqxmd.com/read/27333357/practice-bulletin-no-165-prevention-and-management-of-obstetric-lacerations-at-vaginal-delivery
#17
(no author information available yet)
Lacerations are common after vaginal birth. Trauma can occur on the cervix, vagina, and vulva, including the labial, periclitoral, and periurethral regions, and the perineum. Most of these lacerations do not result in adverse functional outcomes. Severe perineal lacerations, extending into or through the anal sphincter complex, although less frequent, are more commonly associated with increased risk of pelvic floor injury, fecal and urinary incontinence, pain, and sexual dysfunction with symptoms that may persist or be present many years after giving birth...
July 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27333355/practice-bulletin-no-165-summary-prevention-and-management-of-obstetric-lacerations-at-vaginal-delivery
#18
(no author information available yet)
Lacerations are common after vaginal birth. Trauma can occur on the cervix, vagina, and vulva, including the labial, periclitoral, and periurethral regions, and the perineum. Most of these lacerations do not result in adverse functional outcomes. Severe perineal lacerations, extending into or through the anal sphincter complex, although less frequent, are more commonly associated with increased risk of pelvic floor injury, fecal and urinary incontinence, pain, and sexual dysfunction with symptoms that may persist or be present many years after giving birth...
July 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27279407/laparoscopic-repair-in-children-with-traumatic-bladder-perforation
#19
Cetin Ali Karadag, Burak Tander, Basak Erginel, Dilek Demirel, Unal Bicakci, Mithat Gunaydin, Nihat Sever, Ferit Bernay, Ali Ihsan Dokucu
Here, we report two patients with a traumatic intraperitoneal bladder dome rupture repaired by laparoscopic intracorporeal sutures. The first patient was a 3-year old boy was admitted with a history of road accident. He had a traumatic lesion on his lower abdomen and a pelvic fracture. Computed tomography (CT) scan revealed free intraabdominal fluid. The urethragram showed spreading contrast material into the abdominal cavity. Laparoscopic exploration revealed a 3-cm-length perforation at the top of the bladder...
July 2016: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/27272501/do-pelvic-floor-muscle-exercises-reduce-postpartum-anal-incontinence-a-randomised-controlled-trial
#20
H H Johannessen, A Wibe, A Stordahl, L Sandvik, S Mørkved
OBJECTIVE: To evaluate the effect of pelvic floor muscle exercises (PFME) for postpartum anal incontinence (AI). DESIGN: A parallel two-armed randomised controlled trial stratified on obstetrical anal sphincter injury with primary sphincter repair and hospital affinity. SETTING: Ano-rectal specialist out-patient clinics at two hospitals in Norway. POPULATION: One hundred and nine postpartum women with AI at baseline...
June 7, 2016: BJOG: An International Journal of Obstetrics and Gynaecology
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