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Anorectal dysfunction

Abdul H Sultan, Ash Monga, Joseph Lee, Anton Emmanuel, Christine Norton, Giulio Santoro, Tracy Hull, Bary Berghmans, Stuart Brody, Bernard T Haylen
INTRODUCTION: The terminology for anorectal dysfunction in women has long been in need of a specific clinically-based Consensus Report. METHODS: This Report combines the input of members of the Standardization and Terminology Committees of two International Organizations, the International Urogynecological Association (IUGA) and the International Continence Society (ICS), assisted on Committee by experts in their fields to form a Joint IUGA/ICS Working Group on Female Anorectal Terminology...
October 22, 2016: Neurourology and Urodynamics
Adil E Bharucha, Tae Hee Lee
Although pelvic pain is a symptom of several structural anorectal and pelvic disorders (eg, anal fissure, endometriosis, and pelvic inflammatory disease), this comprehensive review will focus on the 3 most common nonstructural, or functional, disorders associated with pelvic pain: functional anorectal pain (ie, levator ani syndrome, unspecified anorectal pain, and proctalgia fugax), interstitial cystitis/bladder pain syndrome, and chronic prostatitis/chronic pelvic pain syndrome. The first 2 conditions occur in both sexes, while the latter occurs only in men...
October 2016: Mayo Clinic Proceedings
Atika Mallek, Salma Jeribi, Sourour Yaiich, Habib Eleuch, Sameh Ghroubi
OBJECTIVE: To translate and linguistically validate in classical Arabic the French version of the neurogenic bowel dysfunction (NBD). MATERIAL/PATIENTS AND METHODS: The Arabic translation was obtained using the "forward translation/backward translation" method. Multiple sclerosis patients and spinal cord injury patients were included. Clinical measures involved the evaluation of the intestinal and anorectal dysfunction. Patients were asked to respond to a questionnaire twice within a 15-day interval...
September 2016: Annals of Physical and Rehabilitation Medicine
Y Mazor, R Hansen, G Prott, J Kellow, A Malcolm
BACKGROUND: A subset of patients with chronic constipation display a relatively high manometric rectal pressure on strain. We hypothesized that these patients represent a unique phenotype of functional defecatory disorder (FDD) and would benefit from undergoing anorectal biofeedback (BF). METHODS: Of 138 consecutive patients with chronic constipation and symptoms of FDD, 19 were defined as having a high rectal pressure on strain, using a statistically derived cut-off of 78 mm Hg...
September 20, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Giuseppe Giuliani, Francesco Guerra, Diego Coletta, Marco La Torre, Giorgio Franco, Costantino Leonardo, Aldo Infantino, Filippo La Torre
AIM: Rectourethral fistula (RUF) is a rare complication of radical prostatectomy. We report a trans-perineal approach using a fibrin sealant haemostatic patch. METHOD: Five consecutive patients who developed RUF following radical prostatectomy had a direct transperineal repair with a haemostatic patch (TachoSil(®) ) and were assessed at a median follow up of 35.5 (21-45) months. RESULTS: There were no early postoperative complications. The average length of hospital stay was 5 (4-7) days...
September 15, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
V Balaya, C Ngo, L Rossi, C Cornou, C Bensaid, R Douard, A S Bats, F Lecuru
Radical hysterectomy (RH) is an effective treatment for early-stage cervical cancer IA2 to IIA1 but RH is often associated with several significant complications such as urinary, anorectal and sexual dysfunction due to pelvic nerve injuries. Pelvic autonomic nerves including the superior hypogastric plexus (SHP), hypogastric nerves (HN), pelvic splanchnic nerves (PSN), sacral splanchnic nerves (SSN), inferior hypogastric plexus (IHP) and efferent branches of the IHP. We aimed to precise the neuroanatomy of the female pelvis in order to provide key-points of surgical anatomy to improve NSRH for cervical cancer...
September 2016: Gynécologie, Obstétrique & Fertilité
Kristiina Kyrklund, Seppo Taskinen, Risto J Rintala, Mikko P Pakarinen
PURPOSE: - Sexual dysfunction and impairment of quality of life due to fecal incontinece were common after classical operations for anorectal malformations. We hypothesised that modern repairs may have improved outcomes. MATERIALS AND METHODS: A single-institution, cross-sectional study. After ethical approval, all patients ≥16 years of age treated for rectourethral-, vestibular- and perineal fistula from 1983 were went detailed postal questionnaires on sexual function and quality of life...
August 17, 2016: Journal of Urology
Ali Zifan, Melissa Ledgerwood-Lee, Ravinder K Mittal
BACKGROUND & AIMS: Three-dimensional high-definition anorectal manometry (3D-HDAM) is used to assess anal sphincter function; it determines profiles of regional pressure distribution along the length and circumference of the anal canal. There is no consensus, however, on the best way to analyze data from 3D-HDAM to distinguish healthy individuals from persons with sphincter dysfunction. We developed a computer analysis system to analyze 3D-HDAM data and to aid in the diagnosis and assessment of patients with fecal incontinence (FI)...
July 25, 2016: Clinical Gastroenterology and Hepatology
A Mallek, M H Elleuch, S Ghroubi
OBJECTIVE: To translate and linguistically validate in classical Arabic; the French version of the neurogenic bowel dysfunction (NBD). PATIENTS AND METHODS: Arabic translation of the NBD score was obtained by the "forward translation/backword translation" method. Patients with multiple sclerosis (MS) and spinal cord injury were included. Evaluation of intestinal and anorectal disorders was conducted by the self-administered questionnaire NBD, which was filled twice two weeks apart...
September 2016: Progrès en Urologie
Audrius Dulskas, Povilas Miliauskas, Renatas Tikuisis, Ricardo Escalante, Narimantas E Samalavicius
Introduction For more than the last 20 years, low anterior resection with total mesorectal excision (TME) is a gold standard for rectal cancer treatment. Oncological outcomes have improved significantly and now more and more reports of functional outcomes appear. Due to the close relationship between the rectum and pelvic nerves, bowel, bladder, and sexual function are frequently affected during TME. Methods A search for published data was performed using the MEDLINE database (from 1 January 2005 to 31 January 2015) to perform a systematic review of the studies that described anorectal, bladder, and sexual dysfunction following rectal cancer surgery...
February 2016: Acta Chirurgica Belgica
Satish S C Rao, Tanisa Patcharatrakul
Dyssynergic defecation is common and affects up to one half of patients with chronic constipation. This acquired behavioral problem is due to the inability to coordinate the abdominal and pelvic floor muscles to evacuate stools. A detailed history, prospective stool diaries, and a careful digital rectal examination will not only identify the nature of bowel dysfunction, but also raise the index of suspicion for this evacuation disorder. Anorectal physiology tests and balloon expulsion test are essential for a diagnosis...
July 30, 2016: Journal of Neurogastroenterology and Motility
Laure Luciano, Brigitte Granel, Emmanuelle Bernit, Jean-Robert Harle, Karine Baumstarck, Jean-Charles Grimaud, Michel Bouvier, Véronique Vitton
OBJECTIVES: In systemic sclerosis (SSc), esophageal and anorectal involvements are frequent and often associated with each other. In clinical practice, esophageal explorations are often prescribed, while anorectal explorations are rarely proposed and therefore, under-recognised. However, it is well documented in the literature that early detection of anorectal dysfunction could delay and/or prevent the onset of symptoms such as fecal incontinence (FI). The main objective was the systematic evaluation and detection of esophageal and anorectal involvements in SSc patients...
May 24, 2016: Clinical and Experimental Rheumatology
L Ambartsumyan, A Siddiqui, S Bauer, S Nurko
BACKGROUND: Children with urinary incontinence (UI) have associated functional constipation (FC) and fecal incontinence (FI). The physiology between lower urinary tract (LUT) and anorectum in children has not been elucidated. AIMS: Observe the effect of rectal distention (RD) on LUT function, and bladder filling and voiding on anorectal function. METHODS: Children with voiding dysfunction referred to Boston Children's Hospital were prospectively enrolled in combined urodynamic (UDS) and anorectal manometry (ARM)...
June 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
D W Kauff, K Kronfeld, S Gorbulev, D Wachtlin, H Lang, W Kneist
BACKGROUND: Urinary, sexual and anorectal sequelae are frequent after rectal cancer surgery and were found to be related to intraoperative neurogenic impairment. Neuromonitoring methods have been developed to identify and preserve the complex pelvic autonomic nervous system in order to maintain patients' quality of life. So far no randomized study has been published dealing with the role of neuromonitoring in rectal cancer surgery. METHODS/DESIGN: NEUROS is a prospective two-arm randomized controlled multicenter clinical trial comparing the functional outcome in rectal cancer patients undergoing total mesorectal excision (TME) with and without pelvic intraoperative neuromonitoring (pIONM)...
2016: BMC Cancer
D C Townsend, E V Carrington, U Grossi, R E Burgell, J Y J Wong, C H Knowles, S M Scott
BACKGROUND: Fecal incontinence (FI) is a common and socially disabling condition with obstetric trauma considered the principal etiological factor. This study aimed to systematically evaluate symptom presentation and anorectal function in both females and males with FI. METHODS: One hundred males (M) and 100 age-matched females (F) with FI presenting between 2012 and 2014 were identified from a prospectively collected database. Comparison of clinical (history, symptom profile, and severity using validated questionnaires) and anorectal physiological (manometry, rectal sensory testing, endoanal ultrasonography, and evacuation proctography) data between M and F was performed...
October 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Y Mazor, M Jones, A Andrews, J E Kellow, A Malcolm
STUDY DESIGN: A case-control study of prospectively collected data was performed. OBJECTIVES: To compare anorectal biofeedback (BF) outcomes in patients with incomplete motor spinal cord injury (SCI) and neurogenic bowel dysfunction (NBD) with a group of functional anorectal disorder-matched control patients. SETTING: Neurogastroenterology Unit affiliated with a Spinal Injury Unit in a tertiary referral centre in Sydney, Australia. METHODS: All consecutive patients with SCI and NBD referred for anorectal manometry and BF were matched in a 1:2 ratio with age, gender, parity and functional anorectal disorder-matched control patients...
May 17, 2016: Spinal Cord
Zhuowei Xue, Xiaolu Zhu, Yincheng Teng
BACKGROUND/AIMS: Radical hysterectomy (RH) for the treatment of cervical cancer frequently caused pelvic organ dysfunctions. This study aimed to compare the results of pelvic organ function and recurrence rate after Nerve sparing radical hysterectomy (NSRH) and RH treatment through systematic review and meta-analysis. METHODS: PubMed, Web of Science and China Knowledge Resource Integrated Database were searched from inception to 25 February 2015. Studies of cervical cancer which reported radical hysterectomy or nerve sparing radical hysterectomy were included...
2016: Cellular Physiology and Biochemistry
Andreia Albuquerque, Eduardo Pereira
Transperineal ultrasound is an inexpensive, safe and painless technique that dynamically and non-invasively evaluates the anorectal area. It has multiple indications, mainly in urology, gynaecology, surgery and gastroenterology, with increased use in the last decade. It is performed with conventional probes, positioned directly above the anus, and may capture images of the anal canal, rectum, puborectalis muscle (posterior compartment), vagina, uterus, (central compartment), urethra and urinary bladder (anterior compartment)...
April 28, 2016: World Journal of Radiology
S Palit, N Thin, C H Knowles, P J Lunniss, A E Bharucha, S M Scott
BACKGROUND: Evacuatory dysfunction (ED) is a common cause of constipation and may be sub-classified on the basis of specialist tests. Such tests may guide treatment e.g., biofeedback therapy for 'functional' defecatory disorders (FDD). However, there is no gold standard, and prior studies have not prospectively and systematically compared all tests that are used to diagnose forms of ED. METHODS: One hundred consecutive patients fulfilling Rome III criteria for functional constipation underwent four tests: expulsion of a rectal balloon distended to 50 mL (BE50 ) or until patients experienced the desire to defecate (BEDDV ), evacuation proctography (EP) and anorectal manometry...
October 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Bong-Hyeon Kye, Hyung-Jin Kim, Gun Kim, Ri Na Yoo, Hyeon-Min Cho
We evaluated the effect of biofeedback therapy (BFT) on anorectal function after stoma closure when administered during the interval of temporary stoma after sphincter-preserving surgery for rectal cancer.Impaired anorectal function is common after lower anterior resections, though no specific treatment options are currently available to prevent this adverse outcome.Fifty-six patients who underwent neoadjuvant chemoradiation therapy after sphincter-preserving surgery with temporary stoma were randomized into 2 groups: group 1 (received BFT during the temporary stoma period) and group 2 (did not receive BFT)...
May 2016: Medicine (Baltimore)
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