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Anal incontinence

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https://www.readbyqxmd.com/read/29731315/multiple-neurosurgical-treatments-for-different-members-of-the-same-family-with-currarino-syndrome
#1
N Serratrice, L Fievet, F Albader, D Scavarda, H Dufour, S Fuentes
INTRODUCTION: Currarino's syndrome (CS) is an autosomal dominant disorder of embryonic development causing a rare malformating syndrome characterized by a triad of an anorectal malformations, presacral mass (most commonly an anterior sacral meningocele) and sacral bony defects. Mutations of the HLXB9 gene have been identified in most CS cases, but a precise genotype-phenotype correlation has not been described so far. Family screening is obligatory. The diagnosis is usually made during childhood and rarely in adulthood...
May 3, 2018: Neuro-Chirurgie
https://www.readbyqxmd.com/read/29718243/the-impact-of-age-at-time-of-ileal-pouch-anal-anastomosis-on-short-and-long-term-outcomes-in-adults
#2
Nicholas P McKenna, Kellie L Mathis, John H Pemberton, Amy L Lightner
Background: There is limited knowledge on ileal pouch anal anastomosis (IPAA) function when performed on patients older than age 50 years. The aim of this study was to determine if surgery on those older than age 50 years impacts short-term complications or long-term function. Methods: A retrospective review of all patients undergoing IPAA for chronic ulcerative colitis at a single tertiary referral center between 2002 and 2013 was conducted. Short-term postoperative complications and long-term function and quality of life were analyzed according to age at pouch formation (age >50 vs age ≤50 years)...
April 26, 2018: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29714663/assessment-of-bowel-and-anal-sphincter-function-after-neoadjuvant-chemoradiotherapy-in-locally-advanced-rectal-cancer
#3
Consuelo Rosa, Monica Di Tommaso, Luciana Caravatta, Annamaria Vinciguerra, Antonietta Augurio, Francesca Perrotti, Albina Allajbej, Marco Regoli, Isaia Al Zecca, Marta Di Nicola, Domenico Genovesi
PURPOSE: To report long-term effects on anorectal function and bowel disorders and late toxicity rate of preoperative chemoradiotherapy in patients with locally advanced rectal cancer. METHODS: Between 2000 and 2016, 201 patients treated with different neoadjuvant schedules of chemotherapy and radiotherapy doses were retrospectively analyzed. The Memorial Sloan-Kettering Cancer Center score was used for the evaluation of anal sphincter function. RESULTS: The median follow-up time was 68 months (interquartile range 35-113 months)...
April 1, 2018: Tumori
https://www.readbyqxmd.com/read/29707238/open-surgery-for-haemorrhoids-in-persons-with-spinal-cord-injury
#4
J G Previnaire, N De Bont, H Bordi, N Senal, P E Mortier
Study design: Pilot retrospective study on the outcome of open surgery for grade III and IV haemorrhoids in patients with SCI. Objective: Haemorrhoids and anal fissures are common in patients with spinal cord injury (SCI). Grade I to III haemorrhoids are usually managed medically or by surgical ligation. Grade III and IV haemorrhoids are treated with surgical haemorrhoidectomy in the general population, but not in patients with SCI, most probably due to fear of complications...
2018: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/29706461/abnormal-neuronal-response-to-rectal-and-anal-stimuli-in-patients-treated-with-primary-radiotherapy-for-anal-cancer
#5
Susanne Haas, Pia Faaborg, Mikkel Gram, Lilli Lundby, Christina Brock, Anbjørn M Drewes, Søren Laurberg, Klaus Krogh, Peter Christensen
INTRODUCTION: Sphincter-sparing radiotherapy or chemoradiation (RT/CRT) have become the standard treatments for most patients with anal cancer. Unfortunately, long-term survivors often suffer from severe bowel symptoms indicating sensory dysfunction. The aim of the present study was to characterize the sensory pathways of the brain-gut axis after radiotherapy for anal cancer. METHOD: Cortical evoked potentials (CEPs) were recorded during repeated, rapid balloon distensions of the rectum and anal canal in 13 patients with anal cancer treated with radiotherapy or chemoradiation and in 17 healthy volunteers...
April 26, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/29701198/-a-case-of-severe-obstructive-sleep-apnea-hypopnea-syndrome-with-urinary-and-anal-incontinence
#6
Li Zhou, Ruoyun Ouyang, Ping Chen, Hong Luo, Hanmei Liu, Guiqian Liu
A case of a young male patient, who came to the Second Xiangya Hospital, Central South University because of snoring for 10 years and nocturnal gatism for half month, was analyzed retrospectively. He was diagnosed as obstructive sleep apnea hypopnea syndrome (OSAHS) finally. The patient had been diagnosed and treated as stroke in the local hospital, while urinary and anal incontinence were not relieved. It was a dilemma for him to be properly diagnosed and treated. Polysomnography in our hospital revealed apnea hypopnea index (AHI) at 44...
March 28, 2018: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/29665089/three-dimensional-endoanal-ultrasound-features-of-the-anal-sphincter-in-asian-primigravidae
#7
Dakshitha Praneeth Wickramasinghe, Supun Senaratne, Hemantha Senanayake, Dharmabandu Nandadeva Samarasekera
OBJECTIVES: The normal parameters of 3-dimensional endoanal ultrasound (3DEAUS) of the anal sphincter have not been reported for primigravidae or pregnant women at present. 3DEAUS parameters in Asian primigravidae were assessed in this study. METHODS: We analyzed 3DEAUS data of 101 consecutives Asian primigravidae, assessed in the early third trimester. The assessment was performed with a rigid ultrasonic probe (Olympus® RU 12M-R1 probe and EU-ME1 ultrasound system (Olympus Corp...
April 17, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29651553/fistulectomy-with-primary-sphincter-reconstruction
#8
Steffen Seyfried, Dieter Bussen, Andreas Joos, Christian Galata, Christel Weiss, Alexander Herold
AIM: Despite modern medical techniques, anatomically proximal (high) anal fistulas are still a challenge in colorectal surgery. In previous years, the standard of care was complete fistulectomy with a high rate of continence disorders. Over the past 20 to 30 years, sphincter-saving procedures have gained wide acceptance. They represent the technique used in these cases. Additionally, many patients received indefinite treatment, namely the placement of a seton to maintain surgical drainage...
April 12, 2018: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29643327/comparison-of-effects-of-vessel-sealing-devices-and-conventional-hemorrhoidectomy-on-postoperative-pain-and-quality-of-life
#9
Murat Kendirci, İbrahim Tayfun Şahiner, Yeliz Şahiner, Güven Güney
BACKGROUND The aim of this study was to investigate the early and late results of use of LigaSure, Harmonic Scalpel, and conventional hemorrhoidectomy in hemorrhoidectomy, to determine the least painful method, and to investigate the relationship between pain perception and personal differences in hemorrhoid bundles. MATERIAL AND METHODS Ninety patients undergoing hemorrhoidectomy between 2014 and 2017 were retrospectively evaluated. We investigated the duration of hospitalization and the presence of bleeding, incontinence, perianal wetness, urinary retention, stenosis, and recurrence during follow-up after surgery...
April 12, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29629963/health-care-seeking-characteristics-of-women-with-pelvic-floor-disorders-after-obstetric-anal-sphincter-injury
#10
Jon F Pennycuff, Deborah R Karp, Julia Shinnick, Catherine O Hudson, Gina M Northington
OBJECTIVES: Obstetric anal sphincter injury (OASIS) is a potentially serious complication of vaginal delivery and can lead to both short-term and long-term sequelae. This study sought to identify health care seeking patterns of women who developed pelvic floor symptoms including pelvic pain after OASIS. It also identified demographic and clinical factors associated with seeking subspecialty care from a pelvic floor specialist and demographic and clinical factors associated with seeking care for pelvic pain after OASIS...
April 6, 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29618340/3d-high-resolution-anorectal-manometry-in-patients-with-perianal-fistulas-comparison-with-3d-anal-ultrasound
#11
Richelle J F Felt-Bersma, Maarten S Vlietstra, Paul F Vollebregt, Ingrid J M Han-Geurts, Vera Rempe-Sorm, Grietje J H Vander Mijnsbrugge, Charlotte B H Molenaar
BACKGROUND: Perianal fistula surgery can damage the anal sphincters which may cause faecal incontinence. By measuring regional pressures, 3D-HRAM potentially provides better guidance for surgical strategy in patients with perianal fistulas. The aim was to measure regional anal pressures with 3D-HRAM and to compare these with 3D-EUS findings in patients with perianal fistulas. METHODS: Consecutive patients with active perianal fistulas who underwent both 3D-EUS and 3D-HRAM at a clinic specialised in proctology were included...
April 4, 2018: BMC Gastroenterology
https://www.readbyqxmd.com/read/29617820/fecal-incontinence-in-inflammatory-bowel-disease-a-systematic-review-and-meta-analysis
#12
Phillip Gu, M Ellen Kuenzig, Gilaad G Kaplan, Mark Pimentel, Ali Rezaie
Background: Understanding of the prevalence, pathophysiology, and management of fecal incontinence (FI) in inflammatory bowel disease (IBD) patients without an ileal pouch anal anastomosis (IPAA) is suboptimal. We conducted a systematic review and meta-analysis on the prevalence, pathophysiology, and management of primary FI in IBD patients without IPAA. Methods: We searched MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews (1966 through March 2017) for studies on the prevalence, physiology, or management of FI in IBD patients without IPAA...
March 30, 2018: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29600403/effect-of-subsequent-vaginal-delivery-on-bowel-symptoms-and-anorectal-function-in-women-who-sustained-a-previous-obstetric-anal-sphincter-injury
#13
Polly A Jordan, Madhu Naidu, Ranee Thakar, Abdul H Sultan
INTRODUCTION AND HYPOTHESIS: Our primary objective was to prospectively evaluate anorectal symptoms, anal manometry and endoanal ultrasound (EAUS) in women who followed the recommended mode of subsequent delivery following index obstetric anal sphincter injuries (OASIs) using our unit's standardised protocol. Our secondary objectives were to evaluate the role of internal anal sphincter defects and also to compare outcomes in a subgroup of symptomatic women with normal anorectal physiology...
March 29, 2018: International Urogynecology Journal
https://www.readbyqxmd.com/read/29582182/diagnosis-and-management-of-fecal-incontinence
#14
REVIEW
Arnold Wald
PURPOSE OF REVIEW: The purpose of this review is to highlight current and newer therapeutic approaches to treat fecal incontinence in patients who do not respond to conservative measures. RECENT FINDINGS: Neurostimulation techniques, injection of bulking agents, and radiofrequency energy delivery to the anal canal have been proposed and tested for fecal incontinence over the last decade. Sacral stimulation is both effective and durable and is now the most popular of the invasive techniques whereas percutaneous tibial stimulation, radiofrequency energy, and bulking agents are either less effective or their evaluation has been handicapped by suboptimal study designs...
March 26, 2018: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/29575180/sonographic-assessment-of-the-anal-sphincter-after-obstetric-anal-sphincter-injury-oasi-using-transperineal-ultrasound-tpus
#15
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/29564542/the-puborectal-continence-reflex-a-new-regulatory-mechanism-controlling-fecal-continence
#16
Paul M A Broens, Jara E Jonker, Monika Trzpis
PURPOSE: Fecal continence is maintained by voluntary and involuntary contraction of the anal sphincter, and voluntary contractions of puborectal muscle. We investigated whether the puborectal muscle can control fecal continence not only by voluntary contractions but also by involuntary contractions. METHODS: We performed anorectal function tests in 23 healthy subjects. The anorectal pressure test was used to investigate voluntary contractions of the puborectal muscle...
March 21, 2018: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29564511/it-is-the-first-birth-that-does-the-damage-a-cross-sectional-study-20-years-after-delivery
#17
Ixora Kamisan Atan, Sylvia Lin, Hans Peter Dietz, Peter Herbison, Peter Donald Wilson
INTRODUCTION AND HYPOTHESIS: Levator ani muscle (LAM) and anal sphincter tears are common after vaginal birth and are associated with female pelvic organ prolapse and anal incontinence. The impact of subsequent births on LAM and external anal sphincter (EAS) integrity is less well defined. The objective of this study was to determine the prevalence of LAM and EAS trauma in primiparous (VP1) and multiparous (VP2+) women who had delivered vaginally to assess if there were differences between the two groups...
March 21, 2018: International Urogynecology Journal
https://www.readbyqxmd.com/read/29563038/clinical-manifestations-pathophysiology-treatment-and-outcome-of-inflammatory-bowel-diseases-in-older-people
#18
REVIEW
Matthias Butter, Stefan Weiler, Luc Biedermann, Michael Scharl, Gerhard Rogler, Heike A Bischoff-Ferrari, Benjamin Misselwitz
Approximately 10-20% of inflammatory bowel disease (IBD) cases are diagnosed after 60 years of age. Due to the high prevalence of conditions mimicking IBD at older age - including bowel disease associated with non-steroidal anti-inflammatory drugs, diverticulitis, and microscopic colitis - differential diagnosis of IBD among older adults is frequently delayed. Late-onset IBD is characterized by a predominance of colonic disease and an overall milder disease course; disease progression and new intestinal manifestations are rare...
April 2018: Maturitas
https://www.readbyqxmd.com/read/29560640/manometric-and-ultrasonographic-characteristics-of-patients-with-coexisting-fecal-incontinence-and-constipation
#19
M Somers, C Peleman, K Van Malderen, W Verlinden, S Francque, H De Schepper
BACKGROUND: The treatment of fecal incontinence (FI) depends upon the dominant pathophysiology: impaired sphincter contractility or overflow due to pelvic floor dyssynergia and insufficient rectal emptying. In this study, we aimed to define the manometric and anorectal ultrasound characteristics in FI patients with and without constipation. METHODS: We did a retrospective study of 365 anal manometries, performed between October 2012 and July 2015, in patients with FI...
October 2017: Acta Gastro-enterologica Belgica
https://www.readbyqxmd.com/read/29551608/anal-sphincter-function-as-assessed-by-3d-high-definition-anorectal-manometry
#20
François Mion, Aurélien Garros, Fabien Subtil, Henri Damon, Sabine Roman
PURPOSE: High resolution anorectal manometry has been developed over the past years, as well as 3D high definition manometry (HDARM). However, the clinical impact of the results obtained with these new technologies remains to be determined. We thus analyzed various HDARM parameters of anal sphincter function and tested their capacity to discriminate between patients with constipation and those with fecal incontinence. METHODS: One hundred and fourteen consecutive patients underwent the same HDARM protocol (Medtronic), including 2 short duration voluntary anal contractions (5seconds) and 1 sustained (as long as possible) contraction...
March 15, 2018: Clinics and Research in Hepatology and Gastroenterology
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