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Anal incontinence

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https://www.readbyqxmd.com/read/28061422/can-we-predict-obstetric-anal-sphincter-injury
#1
Kristina Drusany Starič, Petra Bukovec, Katja Jakopič, Eftim Zdravevski, Vladimir Trajkovik, Adolf Lukanović
OBJECTIVE: The aim of the study was to identify primiparous pregnant women with a higher risk for obstetric anal sphincter injuries (OASIS) based on obstetric characteristics (risk factors). STUDY DESIGN: In the retrospective case control study primiparous women were examined using endoanal ultrasonography (EUS) for OASIS identification 6-12 weeks after delivery. Obstetric characteristics for OASIS were collected from the mothers' medical records. The univariate analysis of maternal (age at delivery, maternal height, weight, BMI), infant (length, weight and head circumference) and birth (pregnancy duration, labour and delivery duration, episiotomy, vacuum extraction and oxytocin augmentation) risk factors, Pearson correlations and information gain were carried out...
December 23, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28054134/ultrasonographic-evidence-of-gatekeeper%C3%A2-prosthesis-migration-in-patients-treated-for-faecal-incontinence-a-case-series
#2
F de la Portilla, M L Reyes-Díaz, M V Maestre, R M Jiménez-Rodríguez, A M García-Cabrera, J M Vázquez-Monchul, J M Díaz-Pavón, F C Padillo-Ruiz
BACKGROUND: Faecal incontinence (FI) is both a medical and social problem, with an underestimated incidence. For patients with internal anal sphincter damage, implantation of biomaterial in the anal canal is a recognised treatment option. One such material, Gatekeeper™, has previously shown promising short- and medium-term results without any major complications, including displacement. The main aim of the present study is to assess the degree to which displacement of Gatekeeper prostheses may occur and to determine whether this is associated with patient outcomes...
January 4, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28035460/usefulness-of-anorectal-and-endovaginal-3d-ultrasound-in-the-evaluation-of-sphincter-and-pubovisceral-muscle-defects-using-a-new-scoring-system-in-women-with-fecal-incontinence-after-vaginal-delivery
#3
Sthela M Murad-Regadas, Graziela Olivia da S Fernandes, Francisco Sergio Pinheiro Regadas, Lusmar Veras Rodrigues, Francisco Sergio Pinheiro Regadas Filho, Iris Daiana Dealcanfreitas, Adjra da Silva Vilarinho, Mariana Murad da Cruz
PURPOSE: This study aims to evaluate pubovisceral muscle and anal sphincter defects in women with previous vaginal delivery and fecal incontinence and to correlate the findings with the severity of symptoms using the combined anorectal and endovaginal 3D ultrasonography with a new ultrasound scoring system. METHODS: Consecutive female patients with previous vaginal delivery and fecal incontinence symptoms were screened. Fecal incontinence was assessed with the Cleveland Clinic Florida fecal incontinence scale, and the extent of defects was assessed by an ultrasound score based on results of anorectal and endovaginal 3D ultrasound...
December 29, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28025682/impact-of-subsequent-birth-and-delivery-mode-for-women-with-previous-oasis-systematic-review-and-meta-analysis
#4
REVIEW
Sara S Webb, Derick Yates, Margarita Manresa, Matthew Parsons, Christine MacArthur, Khaled M K Ismail
INTRODUCTION AND HYPOTHESIS: Obstetric anal sphincter injuries (OASIS) are serious complications of vaginal birth. In a pregnancy following OASIS women may be keen to avoid an elective caesarean section, yet cautious about pursuing another vaginal birth that may result in further damage to the pelvic floor and possible long-term anal incontinence. This review aimed to evaluate the impact of subsequent birth and its mode on anal incontinence (AI) and/or quality of life (QoL), for women with previous OASIS...
December 26, 2016: International Urogynecology Journal
https://www.readbyqxmd.com/read/28000182/-current-situation-in-the-diagnosis-and-treatment-of-rectovaginal-fistula
#5
Hui Peng, Donglin Ren
The treatment of rectovaginal fistula is quite difficult. It is a formidable challenge for anorectal surgeons to successfully perform operations for rectovaginal fistulas, since both recurrence rate and incontinence rate are high. This commentary elucidates certain questions during the treatment course of rectovaginal fistula through reviewing relevant literature and our clinical practice, including the overall evaluation of the preoperative rectovaginal fistula, the choice of suitable operation timing, reasonable choice of operational procedure and standard perioperative management...
December 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/27992558/pelvic-floor-disorders-6-months-after-attempted-operative-vaginal-delivery-according-to-the-fetal-head-station-a-prospective-cohort-study
#6
Guillaume Ducarme, Jean-François Hamel, Stéphanie Brun, Hugo Madar, Benjamin Merlot, Loïc Sentilhes
OBJECTIVE: To evaluate the effect of the fetal head station at attempted operative vaginal delivery (aOVD), and specifically midpelvic or low aOVD, on urinary incontinence (UI), anal incontinence (AI), and perineal pain at 6 months. DESIGN: Prospective cohort study. SETTING: 1941 women with singleton term fetuses in vertex presentation with midpelvic or low aOVD between 2008 and 2013 in a tertiary care university hospital. METHODS: Symptoms of urinary incontinence (UI) using the Bristol Female Lower Urinary Tract Symptoms questionnaire, and symptoms of anal incontinence (AI) severity using Fecal Incontinence Severity Index (FISI) were assessed 6 months after aOVD...
2016: PloS One
https://www.readbyqxmd.com/read/27991017/-proctocolectomy-with-j-pouch-ileo-anal-anastomosis-performed-with-pph-stapler-our-experiences-after-88-cases
#7
Csaba Berki, Elemér Mohos, György Réti, Tamás Kovács, Zoltán Jánó, József Mohay, Sándor Horváth, Gábor Bognár, Krisztina Bene, Myroslav Horzov, Gábor Sándor, Gábor Tornai, Petra Mohos, Péter Szenkovits, Tibor Nagy, Csaba Orbán, Vivien Herpai, Attila Nagy
AIM: Ulcerative colitis (CU) or Familiar Polyposis (FAP) can be the indication for proctocolectomy reconstructed with J pouch. The complete removal of the colon mucosa is essential regarding the late complications and at the same time the atraumatic surgical technique is very important concerning on the long term functional results. Both aspects seems to be answered by the stapled ileo-anal anastomosis using a "procedure for prolaps and haemorrhoids (PPH)" stapler applied by us since 2000...
December 2016: Magyar Sebészet
https://www.readbyqxmd.com/read/27981821/low-energy-manual-anal-stretch-an-approach-in-the-treatment-of-chronic-anal-fissure
#8
Fabio Gaj, Ivano Biviano, Laura Candeloro
BACKGROUND: Anal fissure is a tear in the epitelial lining of the anal canal. This is a very common anorectal disorder, but the choice of treatment is unclear. Sphincterotomy is effective but it is affected by a high risk of faecal incontinence. Manual anal stretch is a efficacious, economic and safe maneuver. The aim of this prospective study was to assess the safety and effectiveness of anal stretch in resolving chronic anal fissures. METHODS: Twenty five patients with a clinical diagnosis of chronic anal fissure were submitted to anal stretch...
December 16, 2016: Minerva Chirurgica
https://www.readbyqxmd.com/read/27943527/three-dimensional-endoanal-ultrasound-is-accurate-and-reproducible-in-determining-type-and-height-of-anal-fistulae
#9
M Kołodziejczak, G A Santoro, A Obcowska, Z Lorenc, M Mańczak, I Sudoł-Szopińska
AIM: Surgical treatment of high anal fistulae is associated with potential risk of faecal incontinence and recurrence. The primary aim of this study was to determine the accuracy of three-dimensional endoanal ultrasound (3D-EAUS) in the assessment of height and type of anal fistulae, compared to the intraoperative findings (gold standard). The secondary aim was to evaluate the inter-observer reproducibility of 3D-EAUS. METHODS: The study design was a prospective analysis of retrospective data...
December 10, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/27943520/evaluation-of-anatomical-and-functional-results-of-overlapping-anal-sphincter-repair-with-or-without-the-injection-of-bone-marrow-aspirate-concentrate-a-case-control-study
#10
W W Khafagy, M M El-Said, W M Thabet, S E-S Aref, W Omar, S H Emile, H Elfeki, M S El-Ghonemy, M T El-Shobaky
AIM: Overlapping anal sphincter repair (OASR) is used for treatment of faecal incontinence due to an external anal sphincter (EAS) defect; however, it is not the optimal treatment as its functional results tend to deteriorate significantly with time. The present study aimed to evaluate the effect of local injection of bone marrow aspirate concentrate (BMAC) on the outcome of OASR. METHOD: We compared a prospective group of 20 patients with EAS defect who were managed with OASR and BMAC injection (group I) with a historical control group of an equal number of patients managed with OASR alone (group II)...
January 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/27926562/long-term-experience-of-magnetic-anal-sphincter-augmentation-in-patients-with-fecal-incontinence
#11
Jeremy Sugrue, Paul-Antoine Lehur, Robert D Madoff, Shane McNevin, Steen Buntzen, Søren Laurberg, Anders Mellgren
BACKGROUND: Magnetic anal sphincter augmentation is a novel technique for the treatment of patients with fecal incontinence. OBJECTIVE: The current study reports the long-term effectiveness and safety of this new treatment modality. DESIGN: This was a prospective multicenter pilot study. SETTINGS: The study was performed at 4 clinical sites in Europe and the United States. PATIENTS: The cohort included patients with severe fecal incontinence for ≥6 months who had previously failed conservative therapy and were implanted with a magnetic anal sphincter device between 2008 and 2011...
January 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/27891706/rectal-intussusception-can-high-resolution-three-dimensional-ano-rectal-manometry-compete-with-conventional-defecography
#12
A Benezech, M Cappiello, K Baumstarck, J-C Grimaud, M Bouvier, V Vitton
BACKGROUND: Three-dimensional high-resolution anorectal manometry (3DHRAM), used for exploring anorectal disorders, was recently developed, providing interesting topographic data for the diagnosis of pelvic floor disorders such as excessive perineal descent. The aim of our study was to define a diagnostic strategy based on selected 3DHRAM parameters to identify rectal intussusceptions (RI), considering conventional defecography (CD) as the gold standard. METHODS: All patients referred to our center in the previous 6 months for 3DHRAM to explore fecal incontinence or constipation, and who previously achieved CD, were eligible...
November 27, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/27885800/sacral-neuromodulation-for-the-treatment-of-faecal-incontinence-following-proctectomy
#13
Ido Mizrahi, Sami A Chadi, Nadav Haim, Dana R Sands, Brooke Gurland, Massarat Zutshi, Steven D Wexner, Giovanna da Silva
AIM: This study assessed the effectiveness of sacral neuromodulation (SNM) for faecal incontinence (FI) following proctectomy with colorectal or coloanal anastomosis. METHODS: An IRB-approved database identified patients treated for FI following proctectomy (SNM-P) for benign or malignant disease, who were matched 1:1 by pre-operative Cleveland Clinic Florida Faecal Incontinence Scores (CCF-FIS) with patients without proctectomy (SNM-NP). Primary outcome was change in CCF-FIS...
November 25, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/27881404/novel-insights-into-fecal-incontinence-in-men
#14
Yoav Mazor, Michael Jones, Alison Andrews, John E Kellow, Allison Malcolm
: Fecal incontinence (FI) in men is common, yet data on sex differences in clinical features, physiology, and treatment are scarce. Our aim was to provide insights into FI in males compared with females. Prospectively collected data from 73 men and 596 women with FI in a tertiary referral center were analyzed. Anorectal physiology, clinical characteristics, and outcome of instrumented biofeedback (BF) were recorded. Thirty-one men with FI proceeded to BF and were matched with 62 age-matched women with FI who underwent BF...
January 1, 2017: American Journal of Physiology. Gastrointestinal and Liver Physiology
https://www.readbyqxmd.com/read/27881288/internal-anal-sphincter-clinical-perspective
#15
REVIEW
Lalit Kumar, Anton Emmanuel
OBJECTIVE: To summarise current knowledge of Internal anal sphincter. BACKGROUND: The internal anal sphincter (IAS) is the involuntary ring of smooth muscle in the anal canal and is the major contributor to the resting pressure in the anus. Structural injury or functional weakness of the muscle results in passive incontinence of faeces and flatus. With advent of new assessment and treatment modalities IAS has become an important topic for surgeons. This review was undertaken to summarise our current knowledge of internal anal sphincter and highlight the areas that need further research...
November 20, 2016: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/27878621/clinical-and-functional-results-of-laparoscopic-intersphincteric-resection-for-ultralow-rectal-cancer-is-there-a-distinction-between-the-three-types-of-hand-sewn-colo-anal-anastomosis
#16
Bin Zhang, Ke Zhao, Quanlong Liu, Shuhui Yin, Guangzuan Zhuo, Yujuan Zhao, Jun Zhu, Jianhua Ding
PURPOSE: The purpose of this study is to compare the clinical and functional outcomes of three types of hand-sewn colo-anal anastomosis (CAA) after laparoscopic intersphincteric resection (Lap-ISR) for patients with ultralow rectal cancer. METHODS: A total of 79 consecutive patients treated by Lap-ISR for low-lying rectal cancer in an academic medical center from June 2011 to February 2016. According to the distal tumor margin and individualized anal length, the patients underwent three types of hand-sewn CAA including partial-ISR, subtotal-ISR, and total-ISR...
November 23, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27865742/internal-rectal-prolapse-definition-assessment-and-management-in-2016
#17
L Cariou de Vergie, A Venara, E Duchalais, E Frampas, P A Lehur
Internal rectal prolapse (IRP) is a well-recognized pelvic floor disorder mainly seen during defecatory straining. The symptomatic expression of IRP is complex, encompassing fecal continence (56%) and/or evacuation disorders (85%). IRP cannot be characterized easily by clinical examination alone and the emergence of dynamic defecography (especially MRI) has allowed a better comprehension of its pathophysiology and led to the proposition of a severity score (Oxford score) that can guide management. Decision for surgical management should be multidisciplinary, discussed after a complete work-up, and only after medical treatment has failed...
November 16, 2016: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/27843572/utility-of-high-resolution-anorectal-manometry-and-wireless-motility-capsule-in-the-evaluation-of-patients-with-parkinson-s-disease-and-chronic-constipation
#18
Andrew Su, Rita Gandhy, Carrolee Barlow, George Triadafilopoulos
BACKGROUND: The aetiology of constipation in Parkinson's disease remains poorly understood. Defaecatory dyssynergia, anal sphincter spasticity and slow transit constipation may, individually or collectively, play a role. AIMS: In this retrospective cohort analysis of patients with Parkinson's disease and chronic constipation, we determined the utility of high-resolution anorectal manometry, balloon expulsion and wireless motility capsule testing in defining the underlying aetiology for constipation...
2016: BMJ Open Gastroenterology
https://www.readbyqxmd.com/read/27832426/long-term-outcomes-in-indeterminate-colitis-patients-undergoing-ileal-pouch-anal-anastomosis-function-quality-of-life-and-complications
#19
Katharine L Jackson, Luca Stocchi, Leonardo Duraes, Ahmet Rencuzogullari, Ana E Bennett, Feza H Remzi
INTRODUCTION: It is uncertain whether the outcomes of patients with indeterminate colitis (IC) undergoing ileal pouch-anal anastomosis (IPAA) deteriorate over time. The aim of this study was to determine the long-term pouch function, quality of life, complications, and incidence of Crohn's disease after IPAA for patients with IC compared to ulcerative colitis (UC). METHODS: A case matched analysis was performed on patients undergoing IPAA for pathologically confirmed IC or UC, between 1985 and 2014...
January 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27813487/-quality-of-life-after-colectomy-due-to-ulcerative-colitis
#20
Katrin Gudlaugsdottir, Elsa B Valsdottir, Tryggvi B Stefansson
INTRODUCTION: A significant proportion of patients with ulcerative colitis (UC) undergo colectomy. The aim was to assess the quality of life (QOL) of these patients. MATERIAL AND METHODS: All patients with UC who underwent colectomy at The National University Hospital of Iceland or Akureyri Hospital 1995-2009 were included. 106 patients received three questionnaires. SF-36v2 and EORTC are standardised QOL-questionnaires. The third contained functional questions designed by the researchers...
November 2016: Læknablađiđ
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