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Anal incontinence

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https://www.readbyqxmd.com/read/28721483/the-effectiveness-of-mediolateral-episiotomy-in-preventing-obstetric-anal-sphincter-injuries-during-operative-vaginal-delivery-a-ten-year-analysis-of-a-national-registry
#1
Jeroen van Bavel, Chantal W P M Hukkelhoven, Charlotte de Vries, Dimitri N M Papatsonis, Joey de Vogel, Jan-Paul W R Roovers, Ben Willem Mol, Jan Willem de Leeuw
INTRODUCTION AND HYPOTHESIS: Obstetric anal sphincter injuries (OASIS) are associated with an increased risk of faecal incontinence after vaginal delivery. The aim of this retrospective population-based cohort study was to assess whether mediolateral episiotomy is associated with a reduction in the rate of OASIS during operative vaginal delivery. METHODS: We used data from the Dutch Perinatal Registry (Perined) that includes records of almost all births between 2000 and 2010 in The Netherlands...
July 18, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28718924/preliminary-study-of-a-novel-puborectalis-like-artificial-anal-sphincter
#2
Wentian Jin, Guozheng Yan, Hao Wu, Shan Lu, Zerun Zhou
Artificial anal sphincter (AAS) is an in situ implanted device that acts as a treatment for fecal incontinence regardless of etiology by augmenting the incompetent sphincteric structures. However, AAS is impeded from becoming a valid therapy by its high rate of ischemic complication and malfunction. This article presents an original puborectalis-like artificial anal sphincter (PAAS) that features a low risk of ischemia necrosis and rectal perception remodeling. The device retains continence by reproducing the action, including the pulling and angulating the rectum, of the puborectalis muscle, which forms the anorectal angle and reduces the required clamping pressure...
July 18, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28705784/laparoscopic-proctocolectomy-with-ileal-j-pouch-anal-anastomosis-in-children
#3
Ufuk Ateş, Ergun Ergün, Gülnur Göllü, Gönül Küçük, Aydın Yağmurlu
BACKGROUND/AIMS: We aimed to evaluate postoperative fecal incontinence scales of children who underwent laparoscopic proctocolectomy and ileal J-pouch anastomosis for familial adenomateous polyposis (FAP) and inflammatory bowel disease (IBD). MATERIALS AND METHODS: Fecal incontinence scores were collected at 3 months post-surgery. A retrospective chart review was also performed to obtain the demographic data and operative technical details. RESULTS: The postoperative Wexner Fecal Incontinence Score was 0 in 9 of 11 patients and satisfactory in the remaining two...
July 13, 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/28703110/cell-therapy-in-surgical-treatment-of-fistulas-preliminary-results
#4
Marcin Piejko, Michał Romaniszyn, Julia Borowczyk-Michałowska, Justyna Drukała, Piotr Wałęga
Risk of recurrence after surgical treatment of a recurrent fistula is up to 50%. It has be known that more aggressive surgical treatment is associated with a high risk of anal sphincter damage and leads to incontinence. Several studies have been designed to elaborate minimally invasive treatment of rectovaginal and anal fistulas. The properties of Adipose-derived Stem Cells (ASC) significantly enhance a natural healing potency. Here, we present our experience with combined surgical and cell therapy in the treatment of fistulas...
June 30, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28701263/treatment-for-anal-fissure-is-there-a-safe-option
#5
Justin T Brady, Alison R Althans, Ruel Neupane, Eslam M G Dosokey, Murad A Jabir, Harry L Reynolds, Scott R Steele, Sharon L Stein
BACKGROUND: Surgeons often approach anal fissure with chemical denervation (Botulinum toxin, BT) instead of initial lateral internal sphincterotomy (LIS) due to concerns for long-term incontinence. We evaluated the characteristics and outcomes of patients who received BT or LIS. METHODS: We performed a retrospective chart review of patients undergoing LIS and BT for anal fissure between 2009 and 2015. In 2015, a telephone survey was performed to evaluate durability, long-term incontinence and patient satisfaction...
July 5, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28699286/clinical-anatomy-of-fecal-incontinence-in-women
#6
REVIEW
Priyanka K Kadam-Halani, Lily A Arya, Uduak U Andy
Fecal incontinence is a devastating condition that has a severe impact on quality of life. This condition disproportionately affects women and its incidence is increasing with the aging United States population. Fecal continence is maintained by coordination of a functioning anal sphincter complex, intact sensation of the anorectum, rectal compliance, and the ability to consciously control defecation. Particularly important are the puborectalis sling of the levator ani muscle complex and intact innervation of the central and peripheral nervous systems...
July 12, 2017: Clinical Anatomy
https://www.readbyqxmd.com/read/28695312/use-of-biological-mesh-in-trans-anal-treatment-for-recurrent-recto-urethral-fistula
#7
G Moretto, A Casaril, M Inama
PURPOSE: To report the author's experience on a mini-invasive technique using bioprosthetic plug and a rectal wall flap advancement in the treatment of recurrent recto-urethral fistula. MATERIALS AND METHODS: Between 2013 and 2015, seven patients with recurrent recto-urethral fistula were referred to the Pederzoli Hospital, Peschiera del Garda, Verona, Italy. Intraoperatively all patients were found to have a rectal wall lesion and were treated with urinary and fecal diversion...
July 10, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28689239/structure-function-relationship-of-the-human-external-anal-sphincter
#8
Amanda M Stewart, Mark S Cook, Keisha Y Dyer, Marianna Alperin
INTRODUCTION AND HYPOTHESIS: Obstetrical external anal sphincter (EAS) injury and subsequent dysfunction are leading risk factors for female fecal incontinence (FI). Limited knowledge of the EAS structure-function relationship hinders treatment optimization. We directly measured functionally relevant intrinsic parameters of human EAS and tested whether vaginal delivery alters the EAS structure-function relationship. METHODS: Major predictors of in vivo EAS function were compared between specimens procured from vaginally nulliparous (VN, n = 5) and vaginally parous (VP, n = 7) cadaveric donors: operational sarcomere length (Ls), which dictates force-length relationship; physiological cross-sectional area (PCSA), which determines isometric force-generating capacity; fiber length (Lfn), responsible for muscle excursion and contractile velocity; and muscle stiffness...
July 8, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28688109/root-causes-and-social-consequences-of-birth-injuries-in-western-uganda
#9
Jennifer N Angell, Priscilla Busingye, Gabriel Y-K Ganyaglo, Cheryl A Moyer
Incontinence-inducing delivery injuries, such as obstetric fistula and anal-sphincter tears, are devastating sequelae of prolonged and obstructed labor, and can only be repaired through surgery. Such injuries are most prevalent in settings where delays and limitations in accessing emergency obstetric services are common [1, 2]. The 2011 Demographic and Health Survey of Uganda [3] estimated that 2% of Ugandan women have experienced obstetric fistula and resulting trans-vaginal urine or fecal incontinence. This article is protected by copyright...
July 8, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28685224/a-retrospective-review-of-1495-patients-with-obstetric-anal-sphincter-injuries-referred-for-assessment-of-function-and-endoanal-ultrasonography
#10
G P Thomas, L E Gould, F Casunuran, D A Kumar
AIM: Obstetric anal sphincter injuries are a significant risk factor for faecal incontinence. Correct identification and successful primary repair are important. The aim of this study was to review the outcome of all patients, with an obstetric anal sphincter injury, referred to our unit. METHOD: This is a retrospective review of 1495 patients over a 12-year period. All had a third or fourth degree tear and were referred at 4-months postpartum. RESULTS: Endoanal ultrasonography demonstrated residual sphincter defect in 792 (53%) and normal sphincters, with no evidence of repair, in 661 (44%)...
July 7, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28682972/temperature-controlled-delivery-of-radiofrequency-energy-in-fecal-incontinence-a-randomized-sham-controlled-clinical-trial
#11
Arjan P Visscher, Tze J Lam, Maria M Meurs-Szojda, Richelle J F Felt-Bersma
BACKGROUND: Controlled delivery of radiofrequency energy has been suggested as treatment for fecal incontinence. OBJECTIVE: The aim of this study was to determine whether the clinical response to the radiofrequency energy procedure is superior to sham in patients with fecal incontinence. DESIGN: This was a randomized sham-controlled clinical trial from 2008 to 2015. SETTING: This study was conducted in an outpatient clinic...
August 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28678378/successful-treatment-of-passive-fecal-incontinence-in-an-animal-model-using-engineered-biosphincters-a-3-month-follow-up-study
#12
Jaime L Bohl, Elie Zakhem, Khalil N Bitar
Fecal incontinence (FI) is the involuntary passage of fecal material. Current treatments have limited successful outcomes. The objective of this study was to develop a large animal model of passive FI and to demonstrate sustained restoration of fecal continence using anorectal manometry in this model after implantation of engineered autologous internal anal sphincter (IAS) biosphincters. Twenty female rabbits were used in this study. The animals were divided into three groups: (a) Non-treated group: Rabbits underwent IAS injury by hemi-sphincterectomy without treatment...
July 5, 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28674948/transitional-health-care-for-patients-with-hirschsprung-disease-and-anorectal-malformations
#13
M J Witvliet, N Petersen, E Ekkerman, C Sleeboom, E van Heurn, A F W van der Steeg
BACKGROUND: Hirschsprung disease (HD) and anorectal malformations (ARM) are congenital disorders with potentially lifelong consequences. Although follow-up is performed in most pediatric patients, transfer to adult health care is often problematic. This study assesses transitional care with the help of questionnaires in consultation with adult patients. METHODS: This study was conducted in an outpatient clinic of a pediatric surgical center in the Netherlands. All patients born and treated for ARM or HD before 1992 were invited to visit our clinic...
July 3, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28664741/risk-of-anal-incontinence-in-women-with-inflammatory-bowel-diseases-after-delivery
#14
J Kozeluhova, J Kotyza, K Balihar, M Krcma, M Cedikova, J Karbanova, V Kalis, E Janska, M Matejovic
AIM: The aim of our prospective study was to evaluate the development of postpartum anal incontinence in patients with inflammatory bowel disease (IBD) compared to healthy women. MATERIAL AND METHODS: Patients with IBD and healthy controls enrolled in the study from January 1st 2013 to November 30th 2016 and filled in the anal incontinence questionnaire in the beginning of pregnancy and after vaginal delivery. The results were statistically processed using suitable tests...
2017: Bratislavské Lekárske Listy
https://www.readbyqxmd.com/read/28659668/lateral-internal-partial-sphincterotomy-technique-for-chronic-anal-fissure
#15
Gurel Nessar, Mevlut Topbas
Lateral internal sphincterotomy is used for the treatment of a chronic anal fissure. There is a lack of consensus for the amount of internal sphincter division necessary in the surgical treatment of an anal fissure. The anatomy of the anal sphincters and the subcutaneous partial sphincterotomy technique are presented with fresh anal canal specimen photographs. Lateral internal partial sphincterotomy is performed in 43 patients in the office between 2012 and 2013. The patients were questioned about their bowel habitus and any problem with anal control before the operation...
June 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28657991/age-and-dyssynergia-subtypes-associated-with-normal-sphincter-pressures-in-women-with-fecal-incontinence
#16
Toyia James-Stevenson, Huiping Xu, Michael Heit, Andrea Shin
OBJECTIVES: Fecal incontinence (FI) is frequently associated with low sphincter pressures, sensory abnormalities, and advanced age. Twenty-three percent of patients with FI and 22% of healthy patients demonstrate dyssynergic defecation (DD) on high-resolution anorectal manometry. Overflow incontinence occurs in some DD patients with normal resting and squeeze anal sphincter pressures. Our aim was to identify factors associated with normal sphincter pressures in women with FI. METHODS: We reviewed medical records of 134 women with FI...
June 27, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28649718/anal-sphincters-evaluation-by-endoanal-ultrasound-in-obstructed-defecation
#17
Andreia Albuquerque, Guilherme Macedo
OBJECTIVES: To evaluate anal sphincter abnormalities detected by endoanal ultrasound in obstructed defecation due to rectocele and rectal intussusception. METHODS: The retrospective analysis includes 45 patients with obstructed defecation syndrome due to rectocele and/or rectal intussusception with or without fecal incontinence, and submitted to endoanal ultrasound. RESULTS: Ninety-three percent (n = 42) were women (mean age of 63 ± 12 years), and 47% (n = 21) of the patients had fecal incontinence...
June 26, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28628271/surgical-treatment-of-trans-sphincteric-anal-fistulas-with-the-fat-graft-technique-a-minimally-invasive-procedure
#18
N Stroumza, G Fuzco, J Laporte, R Nail Barthelemy, S Houry, M Atlan
AIM: Anal fistulas are common pathologies with a significant social impact; however their treatment is often complex and the recurrence rate can be significant. Some surgical treatments for fistula are also associated with the risk of sphincter injury. In this technical note, we aim to evaluate the feasibility and efficacy of the Fat GRAFT technique (Fat Grafting in Anal Fistula Treatment) in the treatment of recurrent anal fistulas. METHOD: All patients presenting with recurrent trans-sphincteric anal fistulas over an 18-month period were included...
June 19, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28626856/delivery-parameters-neonatal-parameters-and-incidence-of-urinary-incontinence-6-months-postpartum-a-cohort-study
#19
Stian Langeland Wesnes, Yngvild Hannestad, Guri Rortveit
INTRODUCTION: Contradictory results have been reported regarding most delivery parameters as risk factors for urinary incontinence. We investigated the association between incidence of urinary incontinence six months postpartum and single obstetric risk factors as well as combinations of risk factors. MATERIAL AND METHOD: This study was based on the Norwegian Mother and Child Cohort Study, conducted by the Norwegian Institute of Public Health during 1998-2008. This substudy was based on 7561 primiparous women who were continent before and during pregnancy...
June 19, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28610905/anal-cancer-french-intergroup-clinical-practice-guidelines-for-diagnosis-treatment-and-follow-up-snfge-ffcd-gercor-unicancer-sfcd-sfed-sfro-snfcp
#20
REVIEW
Laurence Moureau-Zabotto, Veronique Vendrely, Laurent Abramowitz, Christophe Borg, Eric Francois, Diane Goere, Florence Huguet, Didier Peiffert, Laurent Siproudhis, Michel Ducreux, Olivier Bouché
INTRODUCTION: This document is a summary of the French Intergroup guidelines regarding the management of anal carcinomas, published in November 2016. METHODS: It is a collaborative work produced under the auspices of the majority of the French medical societies involved in the management of anal cancer. It is based on the previous guidelines published in 2010. Recommendations are graded in three categories, according to the amount of evidence found in the literature...
August 2017: Digestive and Liver Disease
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