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Pelvic dysfunction

Judith S Moore, Peter R Gibson, Richard E Perry, Rebecca E Burgell
A diverse range of conditions share symptoms commonly identified with irritable bowel syndrome. The objective of this study was to examine the diagnostic process in identifying additional diagnoses in women who are attending a clinic for evaluation of symptoms suggestive of irritable bowel syndrome. A retrospective audit was conducted of anonymous data gathered on consecutive female patients presenting to a specialist nurse-led service in Christchurch, New Zealand, with a provisional diagnosis of irritable bowel syndrome...
November 8, 2018: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
Graham C Chapman, David Sheyn, Andrey Petrikovets, Sangeeta T Mahajan, Sherif El-Nashar, Robert Pollard, Jeffrey M Mangel
OBJECTIVE: This study aimed to determine the effect of tamsulosin on postoperative urinary retention in female patients after pelvic reconstructive surgery. METHODS: Data were obtained from a retrospective, matched cohort of female patients who were admitted after pelvic reconstructive surgery at a single academic institution. Patients who received tamsulosin were compared with those who did not at a 1:4 ratio, matched by surgical procedure. Patients were excluded if they were discharged on the day of surgery or if an intraoperative complication necessitated prolonged postoperative bladder drainage...
November 9, 2018: Female Pelvic Medicine & Reconstructive Surgery
Ron Golan, Neal A Patel, Tianyi Sun, Christopher E Barbieri, Art Sedrakyan, James A Kashanian
INTRODUCTION: Considering that radiation therapy (RT) compromises soft tissue microvasculature, impairs wound healing, and causes cavernosal fibrosis, inflatable penile prosthesis (IPP) outcomes may be adversely affected in men treated with RT. AIM: To compare IPP outcomes among those who had undergone prior RT vs a cohort who underwent radical prostatectomy (RP) before insertion of IPP. METHODS: The Surveillance, Epidemiology, and End Results (SEER)-Medicare Database was queried for men with prostate cancer (PCa) who underwent RT (n = 83,277) or RP (n = 32,608) with subsequent IPP insertion between 2002 and 2013...
November 2018: Journal of Sexual Medicine
Spyridon Skoufias, Mikaël Sturny, Rodrigo Fraga-Silva, Theodore G Papaioannou, Nikolaos Stergiopoulos, Ioannis Adamakis, Constantinos A Constantinides
INTRODUCTION: Many studies have shown that electrostimulation of the cavernosal nerve can induce and maintain penile erection. Based on these discoveries, neurostimulation to activate the erectile response has been considered a potential solution to treat erectile dysfunction (ED). However, despite recognized potential, this technology has not been further developed. The barrier is the complex anatomy of the human cavernous nerve, which challenges the intraoperative identification of the cavernosal nerves for electrode placement...
November 2018: Journal of Sexual Medicine
Marah Hehemann, Shawn Choe, Elizabeth Kalmanek, Daniel Harrington, Samuel I Stupp, Kevin T McVary, Carol A Podlasek
Urinary incontinence affects 40% of elderly men, is common in diabetic patients and in men treated for prostate cancer, with a prevalence of up to 44%. Seventy-two percent of prostatectomy patients develop stress urinary incontinence (SUI) in the first week after surgery and individuals who do not recover within 6 months generally do no regain function without intervention. Incontinence has a profound impact on patient quality of life and a critical unmet need exists to develop novel and less invasive SUI treatments...
November 6, 2018: Scientific Reports
Holly N Thomas, Genevieve S Neal-Perry, Rachel Hess
Sexual function is an important component of quality of life for women. Midlife poses several challenges to optimal sexual function and intimacy for women. In addition to anatomic factors related to estrogen deficiency, such as genitourinary syndrome of menopause, vulvovaginal atrophy, and pelvic organ prolaps, psychosocial factors, including prior sexual trauma, play an important role in sexual function in women. Several treatments have emerged for female sexual dysfunction; long-term studies and head-to-head comparisons are lacking...
December 2018: Obstetrics and Gynecology Clinics of North America
Karen L Noblett, Kristen Buono
Sacral nerve stimulation delivers nonpainful electrical pulses to the sacral nerves that modulate the reflexes that control the bladder, bowels, and pelvic floor musculature. This relatively simple procedure was generated to improve and restore function in patients with a variety of pelvic floor disorders. Currently this therapy is approved for use in patients with urgency urinary incontinence, urinary urgency-frequency, nonobstructive urinary retention, and fecal incontinence. This review includes the history of this treatment modality, explains the mechanism of action, and describes the procedure for implantation of this device...
November 5, 2018: Obstetrics and Gynecology
R de Tayrac, C Schantz
OBJECTIVES: To assess whether pelvic size and shape, spinal curvature, perineal body length and genital hiatus size are associated with the incidence of childbirth pelvic floor trauma. Special situations, such as obesity, ethnicity and hyperlaxity, will also be studied. METHODS: A bibliographic research using Pubmed and Cochrane Library databases was conducted until May 2018. Publications in English and French were selected by initial reading of the abstracts. Randomized trials, meta-analyzes, case-control studies and large cohorts were studied in a privileged way...
November 2, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Ryan Dobbs, Elizabeth Kalmanek, Shawn Choe, Daniel A Harrington, Samuel I Stupp, Kevin T McVary, Carol A Podlasek
INTRODUCTION: Erectile dysfunction (ED) is a significant health concern that greatly impacts quality of life, and is common in men as they age, impacting 52% of men between the ages of 40 and 70. A significant underlying cause of ED development is injury to the cavernous nerve (CN), a peripheral nerve that innervates the penis. CN injury also occurs in up to 82% of prostatectomy patients. We recently showed that Sonic hedgehog (SHH) protein delivered by peptide amphiphile (PA) nanofiber hydrogel to the CN and penis of a prostatectomy model of CN injury, is neuroprotective, accelerates CN regeneration, improves erectile function ~60%, preserves penile smooth muscle 56% and suppresses collagen deposition 30%...
November 2, 2018: Experimental Neurology
Pernille Palm, Ann-Dorthe Olsen Zwisler, Jesper Hastrup Svendsen, Lau Casper Thygesen, Annamaria Giraldi, Karina Gregersen Jensen, Jane Lindschou, Per Winkel, Christian Gluud, Elaine Steinke, Selina Kikkenborg Berg
BACKGROUND: Sexual dysfunction is common in patients with either ischaemic heart disease (IHD) or implantable cardioverter defibrillator (ICD) and has a negative impact on quality of life. Non-pharmacological treatment options are lacking. The purpose of this trial was to assess the effect of sexual rehabilitation versus usual care for males with erectile dysfunction and either IHD and/or ICD. METHODS: Participants with erectile dysfunction and IHD and/or ICD were randomised to 12 weeks of sexual rehabilitation consisting of physical exercise training, pelvic floor exercise and psychoeducation, or usual care...
October 31, 2018: Heart: Official Journal of the British Cardiac Society
Marc R J Ten Broek, Erik T Te Beek, Roos E Stuurman-Wieringa
We report a case of a 49-year-old woman with a rare anomaly, intrathoracic renal ectopia. Her medical history includes a surgically corrected congenital diaphragmatic hernia, which can cause late presentations of diaphragmatic hernia in adult life. The Tc-MAG3 renogram demonstrated slower emptying of the dilated pelvis of the ectopic kidney than the normal kidney. The curve confirmed a delayed Tmax, followed by a distinct decline. These features are not indicative of a complete obstruction, but can result from partial obstruction, renal dysfunction with poor response to diuresis, pelvic dilatation (such as in our patient), or a combination...
October 27, 2018: Clinical Nuclear Medicine
Gloria A Bachmann, Candace S Brown, Nancy A Phillips, Leslie A Rawlinson, Xinhua Yu, Ronald Wood, David C Foster
BACKGROUND: Sexual dysfunction is common in women with vulvodynia. OBJECTIVE: 1. To evaluate whether extended-release gabapentin is more effective than placebo in improving sexual function in women with provoked vulvodynia, and if there is a relationship between treatment outcome and pelvic pain muscle severity evaluated by palpation with standardized applied pressure. 2. To evaluate whether sexual function in women with PVD would approach that of controls who report no vulvar pain either before or after treatment...
October 23, 2018: American Journal of Obstetrics and Gynecology
David O Prichard, Adil E Bharucha
Constipation, a condition characterized by heterogeneous symptoms, is common in Western society. It is associated with reduced physical health, mental health, and social functioning. Because constipation is rarely due to a life-threatening disease (for example, colon cancer), current guidelines recommend empiric therapy. Limited surveys suggest that fewer than half of treated individuals are satisfied with treatment, perhaps because the efficacy of drugs is limited, they are associated with undesirable side effects, or they may not target the underlying pathophysiology...
2018: F1000Research
Nicole J McConnell, J Ryan Stewart, Alexandra Martin, Jeremy T Gaskins, Erin E Medlin
OBJECTIVES: Women with gynecologic cancer may also present with pelvic floor dysfunction that can have a significant effect on quality of life. Combined surgical intervention for both malignancy and pelvic floor dysfunction may improve quality of life with minimal additional risk. We sought to determine the safety, feasibility, and frequency of combined gynecologic cancer surgery and surgery for pelvic floor dysfunction. METHODS: This is a retrospective cohort study that utilized the National Surgical Quality Improvement Program database provided through the American College of Surgeons...
October 22, 2018: Female Pelvic Medicine & Reconstructive Surgery
Chethan Ramprasad, Jane Yellowlees Douglas, Baharak Moshiree
Gastrointestinal disturbances are seen in nearly all patients with Parkinson's disease and lead to impaired quality of life, affect drug pharmacodynamics, and potentially worsen patient's existing motor fluctuations, leading to further disability. Recent evidence links abnormal accumulations of α-synuclein aggregates in the periphery (gut) as seen in the cortex which causes dysfunctions impacting every level of the gastrointestinal tract from the esophagus, to the stomach, small bowel, colon, and rectum and can even predate the onset of the central neurologic disorder itself...
October 25, 2018: Current Treatment Options in Gastroenterology
Ana Eliza Rios de Araújo Mathias, Márcia Silva de Oliveira, Carolina Mayumi Haruta, Fábia Maria de Lima, Kátia Cristina Lima de Petribú, Geraldo de Aguiar Cavalcanti, Steven E Swift, Alessandro Digesu
INTRODUCTION AND HYPOTHESIS: Our aim was to validate the Brazilian Portuguese version of the International Federation of Gynecology and Obstetrics (FIGO) Assessment Scoring System (FASS) to identify and quantify signs and symptoms related to pelvic floor dysfunction. METHODS: One hundred and seventy-nine women aged 18-82 (47.68 ± 14.42) years participated in this validation study. Collected data included a sociodemographic and clinical questionnaire, application of the FASS, and physical examination using the Pelvic Prgan Prolapse Quantification (POP-Q) system...
October 24, 2018: International Urogynecology Journal
Abby S Taylor, Jackson J Cabo, Chelsea Lauderdale, Narges Maskan, John C Thomas, Stacy T Tanaka, John C Pope, Mark C Adams, John W Brock, Chevis N Shannon, Douglass B Clayton
INTRODUCTION: Pelvic Floor Biofeedback Therapy (PFBT) can be an effective treatment for pediatric lower urinary tract symptoms (LUTS). Due to differing perceptions of efficacy and practice patterns, we sought to further evaluate PFBT in our practice. We hypothesized that PFBT results in quiescence of EMG activity during voiding and improves questionnaire scores in patients with LUTS. METHODS: We retrospectively reviewed all patients undergoing PFBT and refined the analysis to females ≥6 years old with ≥2 sessions with completed voiding questionnaires pre- and post-treatment, active EMG during voiding, with non-neurogenic urinary tract complaints refractory to standard urotherapy...
October 23, 2018: Neurourology and Urodynamics
Bence Kozma, Attila Majoros, Ákos Pytel, Róbert Póka, Péter Takács
Percutaneous tibial nerve stimulation (PTNS) is a minimally invasive, safe and well-tolerated neuromodulation technique for the lower urinary tract dysfunctions. PTNS delivers neuromodulation to the pelvic floor through the S2-4 junction of the sacral nerve plexus via the route of the posterior tibial nerve. Using the fine needle electrode insertion above the ankle, the tibial nerve is accessed, which connected to the stimulator. To date despite of its excessive clinical use, PTNS mechanism of action still remains unclear...
October 2018: Orvosi Hetilap
Erin G Dengler, Louisa A Mounsey, Francesca Gines, Manahil Agha, Terri Long, Elizabeth J Geller
INTRODUCTION AND HYPOTHESIS: Pessaries provide first-line therapy for women with pelvic organ prolapse (POP) and stress urinary incontinence (SUI). The primary hypothesis was that defecatory dysfunction was associated with pessary discontinuation. METHODS: This was a retrospective cohort study of all women undergoing first pessary placement at one academic center from April 2014 to January 2017. Defecatory dysfunction was defined as the presence of constipation, rectal straining, rectal splinting, and/or incomplete defecation...
October 20, 2018: International Urogynecology Journal
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