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https://www.readbyqxmd.com/read/29786037/preliminary-outcome-of-individualized-abdominoperineal-excision-for-locally-advanced-low-rectal-cancer
#1
Yi Zheng, Jia-Gang Han, Zhen-Jun Wang, Zhi-Gang Gao, Guang-Hui Wei, Zhi-Wei Zhai, Bao-Cheng Zhao
Background: The introduction of individualized abdominoperineal excision (APE) may minimize operative trauma and reduce the rate of complications. The purpose of this study was to evaluate the safety and efficacy of individualized APE for low rectal cancer. Methods: Fifty-six patients who underwent individualized APE from June 2011 to June 2015 were evaluated retrospectively in Beijing Chaoyang Hospital, Capital Medical University. The main outcome measures were circumferential resection margin (CRM) involvement, intraoperative perforation, postoperative complications, and local recurrence...
June 5, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29785548/operative-vaginal-delivery-in-case-of-persistent-occiput-posterior-position-after-manual-rotation-failure-a-6-month-follow-up-on-pelvic-floor-function
#2
Paul Guerby, Olivier Parant, Elodie Chantalat, Christophe Vayssiere, Fabien Vidal
PURPOSE: To compare the short- and long-term perineal consequences (at 6 months postpartum) and short-term neonatal consequences of instrumental rotation (IR) to those induced by assisted delivery (AD) in the occiput posterior (OP) position, in case of manual rotation failure. METHODS: A prospective observational cohort study; tertiary referral hospital including all women presenting with persistent OP position who delivered vaginally after manual rotation failure with attempted IR or AD in OP position from September 2015 to October 2016...
May 21, 2018: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29777348/the-effect-of-labor-epidural-analgesia-on-maternal-fetal-outcomes-a-retrospective-cohort-study
#3
Qian Wang, Sheng-Xing Zheng, Yu-Fei Ni, Yuan-Yuan Lu, Bing Zhang, Qing-Quan Lian, Ming-Pin Hu
PURPOSE: To evaluate the impact of labor epidural analgesia on maternal-fetal safety outcomes in a signal Chinese academic medical center. METHODS: A single-intervention impact study was conducted at The Second Affiliated Hospital, Wenzhou Medical University. The study period was divided into three phases: (1) baseline phase: from January 1 and June 30, 2009 when no analgesic method was routinely employed during labor; (2) phase-in period: the epidural analgesia was implemented 8 a...
May 18, 2018: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29768662/immersion-in-water-during-labour-and-birth
#4
REVIEW
Elizabeth R Cluett, Ethel Burns, Anna Cuthbert
BACKGROUND: Water immersion during labour and birth is increasingly popular and is becoming widely accepted across many countries, and particularly in midwifery-led care settings. However, there are concerns around neonatal water inhalation, increased requirement for admission to neonatal intensive care unit (NICU), maternal and/or neonatal infection, and obstetric anal sphincter injuries (OASIS). This is an update of a review last published in 2011. OBJECTIVES: To assess the effects of water immersion during labour and/or birth (first, second and third stage of labour) on women and their infants...
May 16, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29755220/effect-of-mula-bandha-yoga-in-mild-grade-pelvic-organ-prolapse-a-randomized-controlled-trial
#5
K M Sweta, Amrit Godbole, H H Awasthi, Uma Pandey
Background: Pelvic organ prolapse is the growing health issue related to women of the reproductive and postmenopausal age group in India and across the globe. Treatment option for pelvic organ prolapse includes both surgical and non-surgical intervention. The development of pelvic organ prolapse is an indication for major surgery among 20% of all women. Nevertheless, the recurrence of pelvic organ prolapse is detected among 58% of the patient after surgery. This highlights the need for preventive measures for reducing the impact of pelvic organ prolapse...
May 2018: International Journal of Yoga
https://www.readbyqxmd.com/read/29730096/a-qualitative-exploration-of-techniques-used-by-expert-midwives-to-preserve-the-perineum-intact
#6
C Begley, K Guilliland, L Dixon, M Reilly, C Keegan, C McCann, V Smith
BACKGROUND: The perineum stretches during birth to allow passage of the baby, but 85% of women sustain some degree of perineal trauma during childbirth, which is painful post-partum. Episiotomy rates vary significantly, with some countries having rates of >60%. Recent Irish and New Zealand studies showed lower severe perineal trauma and episiotomy rates than other countries. AIM: To explore expert Irish and New Zealand midwives' views of the skills that they employ in preserving the perineum intact during spontaneous vaginal birth...
May 2, 2018: Women and Birth: Journal of the Australian College of Midwives
https://www.readbyqxmd.com/read/29722725/antegrade-enema-after-total-mesorectal-excision-for-rectal-cancer-the-last-chance-to-avoid-definitive-colostomy-for-refractory-low-anterior-resection-syndrome-and-fecal-incontinence
#7
Romain Didailler, Quentin Denost, Paula Loughlin, Edouard Chabrun, Julie Ricard, Flor Picard, Frank Zerbib, Eric Rullier
BACKGROUND: Total mesorectal excision and preoperative radiotherapy in mid and low rectal cancer allow us to achieve very good oncological results. However, major and refractory low anterior resection syndrome and fecal incontinence alter the quality of life of patients with a long expected life span. OBJECTIVE: We assessed the functional results of patients treated by antegrade enema for refractory low anterior resection syndrome and fecal incontinence after total mesorectal excision...
June 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29717299/anorectal-gastrointestinal-stromal-tumour-a-case-treated-with-radical-surgery
#8
Arbin Joshi
Gastrointestinal Stromal Tumour involving rectum and anal canal is an extremely rare entity. This is a case report of a 47 years lady presented with fresh rectal bleed associated with rectal pain and foul smelling rectal mucus discharge. On rectal examination, she had a firm mass palpable about 1.5 cm from anal verge. Considering the size of the tumour and its close proximity with cervix and involvement of levator muscles, extralevator abdominal perineal excision of rectum was undertaken with good recovery after surgery...
March 13, 2018: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/29705985/systematic-review-of-pelvic-floor-interventions-during-pregnancy
#9
REVIEW
Lucas Schreiner, Isabel Crivelatti, Julia M de Oliveira, Christiana C Nygaard, Thais G Dos Santos
BACKGROUND: Pelvic floor interventions during pregnancy could reduce the impact of pregnancy and delivery on the pelvic floor. OBJECTIVE: To determine the effects of pelvic floor interventions during pregnancy on childbirth-related and pelvic floor parameters. SEARCH STRATEGY: PubMed, Embase, and LILACS were searched for reports published during between 1990 and 2016 in English, Spanish, or Portuguese. The search terms were "pregnancy," "pelvic floor muscle training," and related terms...
April 28, 2018: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/29688401/anal-fistulas-in-severe-perineal-crohn-s-disease-mri-assessment-in-the-determination-of-long-term-healing-rates
#10
Charlène Brochard, Amandine Landemaine, Alexandre Merlini L'Heritier, Marie Provost Dewitte, Belinda Tchoundjeu, Tanguy Rohou, Aurélien Garros, Guillaume Bouguen, Laurent Siproudhis
Background & Aims: The European Crohn's and Colitis Organization recommends magnetic resonance imaging (MRI) of anal fistulas to decide on the drug/surgery strategy. No evidence is available on the long-term impact of MRI features on fistula healing. The aim of this study was to evaluate the benefit of combined drug/surgery strategies for the treatment of perianal Crohn's fistulas based on MRI factors at referral. Methods: The clinical event (anal abscess, new fistula tract, cellulitis), therapeutic intervention (introduction/optimization of immunosuppressant/biologics, anal surgery, intestinal resection, stoma), and MRI data were prospectively recorded for patients with Crohn's disease (CD) and anal fistulas...
April 20, 2018: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29681051/voluminous-urethral-stone-a-very-rare-complication-after-male-suburethral-sling-surgery-as-a-result-of-sling-erosion-into-proximal-urethra
#11
Ioan Scarneciu, Cristian Andrei, Camelia Scarneciu, Aura Mihaela Lupu, Ovidiu Gabriel Bratu, Sorin Lupu
Male sling for urinary incontinence is usually accompanied by very good results, with a small number of complications,but, when appear, they may be redundant. Voluminous urethral stone developed on suburethral sling as a result of sling erosion into the proximal urethra is an extremely rare complication (following the analysis of cases published on the internet, the authors of this article no longer identified another similar case). We present the case of a patient who presented in our clinic for severe and permanent urinary incontinence, perineal discomfortand pain that was influenced by position...
April 21, 2018: Urology Journal
https://www.readbyqxmd.com/read/29665978/outpatient-intravenous-multimodal-elastomeric-pump-with-methadone-in-ambulatory-surgery
#12
L Gómez-López, X Sala-Blanch, P L Gambús Cerrillo, A López Gutiérrez, M Agustí Lasús, M T Anglada Casas
BACKGROUND AND OBJECTIVE: Analgesia in Ambulatory Surgery (AS) needs to evolve in parallel with surgical complexity. We designed a study to try to improve analgesia in painful surgery using an intravenous elastomeric pump. As a novelty, methadone was included. PATIENTS AND METHODS: An observational study, physical status ASA I-II, underwent ambulatory surgeries with moderate-severe postoperative pain. Analgesia was administered for 48h by an intravenous multimodal elastomeric pump (methadone, tramadol, dexketoprofen and ondansetron at low doses)...
April 14, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29656064/a-prospective-study-of-patient-reported-pain-after-bulbar-urethroplasty
#13
Patrick Evans, Sorena Keihani, Benjamin N Breyer, Bradley A Erickson, James M Hotaling, Sara M Lenherr, Jeremy B Myers
PURPOSE: To understand the prevalence of chronic perineal pain, activity limitations, and patient satisfaction after urethroplasty. METHODS: From 2014-2016, we prospectively enrolled men undergoing urethroplasty for bulbar urethral strictures. Patients, before and after surgery, completed questions from the Core Lower Urinary Tract Symptom Score (CLSS) assessing pain frequency in the bladder and penis/urethra, as well as non-validated questions assessing perineal pain...
April 12, 2018: Urology
https://www.readbyqxmd.com/read/29648935/episiotomy-and-perineal-tear-risk-factors-in-a-group-of-4493-women
#14
Grażyna Gebuza, Marzena Kaźmierczak, Alicja Gdaniec, Estera Mieczkowska, Małgorzata Gierszewska, Agnieszka Dombrowska-Pali, Mariola Banaszkiewicz, Marek Maleńczyk
Episiotomy belongs to the most frequent procedures carried out during delivery. Performing episiotomy should be reduced as there is scientific evidence indicating that it can cause pain, sexual problems, and serious, long-term health consequences. The aim of the researchers is to identify factors associated with episiotomy and the perineal tear. Analyses were performed using a model of a logistic regression. The study involved 4493 women. The episiotomy risk was related to: a birth weight exceeding 3500 grams, an instrumental delivery by means of forceps or vacuum extraction...
April 12, 2018: Health Care for Women International
https://www.readbyqxmd.com/read/29622704/mucinous-adenocarcinoma-arising-from-chronic-perianal-fistula-mimicking-horseshoe-abscess
#15
Surya Nandan Prasad, Abdul Razik, Farhana Siddiqui, Hira Lal
Perianal fistulae are commonly seen clinical entity. Development of malignancy within a perianal fistula is rare. Even rarer is the development of mucinous adenocarcinoma in a chronic fistula-in-ano. Only a handful of such cases have been reported in the past. A case of mucinous adenocarcinoma arising in chronic perianal fistula in a 34-year-old woman is being described. She presented with complaints of perineal fullness, pain and recurrent pus discharge from perianal fistula for 4 years. On radiological workup, a large solid-cystic pelvic mass was seen in relation to the fistula...
April 5, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29575180/sonographic-assessment-of-the-anal-sphincter-after-obstetric-anal-sphincter-injury-oasi-using-transperineal-ultrasound-tpus
#16
EDITORIAL
Vered H Eisenberg, Dan V Valsky, Simcha Yagel
Obstetric anal sphincter injury (OASI) is the most common cause of anal incontinence and ano-rectal symptoms in women1 . Reported rates of anal incontinence following primary repair of OASI range between 15-61%, with a mean of 39%2, 3 . Other possible complications of OASI include perineal pain, dyspareunia, and less commonly, abscess formation, wound breakdown, and rectovaginal fistulae. Symptom onset may occur immediately, several years postpartum, or only late in life when aging of tissues adds to the delivery insult...
March 24, 2018: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29559867/opiate-prescribing-practices-in-the-postpartum-unit
#17
Angela Nakahara, Nicole D Ulrich, Rajiv Gala
Background: Louisiana is significantly impacted by the opioid epidemic. In preparation for a quality improvement project aimed at decreasing postpartum narcotics prescriptions, we evaluated routine prescribing practices on a postpartum unit and the number of patient-initiated encounters for postpartum pain. Methods: We conducted a retrospective medical record review of all vaginal deliveries occurring at Ochsner Baptist Medical Center in New Orleans, LA in December 2016 and January 2017...
2018: Ochsner Journal
https://www.readbyqxmd.com/read/29559206/retrospective-study-of-the-prevalence-and-risk-factors-of-clitoral-adhesions-women-s-health-providers-should-routinely-examine-the-glans-clitoris
#18
Leen Aerts, Rachel S Rubin, Michael Randazzo, Sue W Goldstein, Irwin Goldstein
INTRODUCTION: The glans clitoris is covered by a prepuce that normally moves over the glans surface and can be retracted beyond the corona. Clitoral adhesions, ranging from mild to severe, occur when preputial skin adheres to the glans. Physical examination consistent with clitoral adhesions is based on the inability to visualize the entire glans corona. In this closed compartment, the space underneath the adherent prepuce and clitoris can become irritated, erythematous, or infected and can result in sexual dysfunction...
March 17, 2018: Sexual Medicine
https://www.readbyqxmd.com/read/29537658/efficiency-of-the-modified-sims-maternal-position-in-the-rotation-of-persistent-occiput-posterior-position-during-labor-a-randomized-clinical-trial
#19
Vanessa Bueno-Lopez, Carmen Fuentelsaz-Gallego, Manel Casellas-Caro, Ana Maria Falgueras-Serrano, Silvia Crespo-Berros, Ana Maria Silvano-Cocinero, Carolina Alcaine-Guisado, Manuela Zamoro Fuentes, Elena Carreras, Carmen Terré-Rull
BACKGROUND: Fetal occiput posterior position in labor is associated with more painful and prolonged labor, and an increase in both maternal and fetal morbidity. The aim of this study is to assess whether the modified Sims position on the side of the fetal spine increases the rotation to occiput anterior position in women with epidural analgesia and a fetus in persistent occiput posterior (POP) position. METHODS: This is an open, randomized controlled, clinical trial...
March 14, 2018: Birth
https://www.readbyqxmd.com/read/29524772/-a-worse-nightmare-than-expected-a-swedish-qualitative-study-of-women-s-experiences-two-months-after-obstetric-anal-sphincter-muscle-injury
#20
Maria Lindqvist, Margareta Persson, Margareta Nilsson, Eva Uustal, Inger Lindberg
OBJECTIVE: this study explores women's experiences of the first two months after obstetric anal sphincter injury (OASIS) during childbirth with a focus on problematic recovery. METHODS: this qualitative study used inductive qualitative content analysis to investigate open-ended responses from 1248 women. The data consists of short and comprehensive written responses to open-ended questions focusing on recovery in the national quality register, the Perineal Laceration Register, two months after OASIS at childbirth...
June 2018: Midwifery
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