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Anal incontinence

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https://www.readbyqxmd.com/read/29139310/pudendal-nerve-injury-impairs-anorectal-function-and-health-related-quality-of-life-measures-%C3%A2-2-years-after-3d-conformal-radiotherapy-for-prostate-cancer
#1
Eng Eric Yeoh, Rochelle Botten, Addolorata Di Matteo, Marcus Tippett, Jonathon Hutton, Robert Fraser, Phillip G Dinning, David Wattchow
PURPOSE: To compare GI symptoms, measures of generic and disease specific health related quality of life (HRQoL), anorectal and pudendal nerve function and anal sphincter morphology between (i) patients ≥2 years after 3D conformal radiotherapy (3D-CRT)±high dose rate (HDR) brachytherapy for carcinoma of the prostate and aged matched patients before radiotherapy and (ii) symptomatic and asymptomatic patients ≥2 years after 3D-CRT ± HDR brachytherapy. MATERIAL AND METHODS: Methodology included: (i) modified LENT-SOMA scales for GI symptoms, (ii) EORTC QLQ-C30 and EORTC QLQ-PR25 questionnaires for generic and disease specific HRQoL, (iii) anorectal manometry and terminal motor latency for anorectal and pudendal nerve function and (iv) endorectal ultrasound for anal sphincter morphology...
November 15, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/29126508/complications-in-children-with-ulcerative-colitis-undergoing-ileal-pouch-anal-anastomosis
#2
Dani O Gonzalez, Benedict C Nwomeh
Total colectomy with ileal pouch-anal anastomosis (IPAA) is considered the standard procedure for the surgical management of ulcerative colitis. Despite the widespread utility of the procedure, as many as 75% of patients who undergo IPAA, experience at least 1 complication. This review highlights difficult intraoperative scenarios and complications of pouch surgery in children, including intraoperative, postoperative, and functional complications. Intraoperative scenarios include insufficient mesenteric length and positive leak tests...
December 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29118540/total-endoscopic-and-anal-irrigation-management-approach-to-noncompliant-neuropathic-bladder-and-bowel-in-children-a-long-term-follow-up
#3
Naif Alqarni, Hamdan Alhazmi, Ossamah Alsowayan, Tamer Eweda, Khalid Fouda Neel
Purpose: To evaluate the long-term efficacy and durability of combined intradetrusor botulinum-A toxin (BTX-A), endoscopic treatment of vesicouerteral reflux and anal irrigation for stool incontinence (SI) via a total endoscopic and anal irrigation management (TEAM(®)) approach in patients with myelomeningocele and neuropathic bladder and bowel who did not respond to conservative measures. Materials and Methods: Fourteen myelomeningocele patients with at least 3 years follow-up were included in the study...
October 2017: Urology Annals
https://www.readbyqxmd.com/read/29117653/effect-of-delivery-and-episiotomy-on-the-emergence-of-urinary-incontinence-in-women-review-of-literature
#4
Krešimir Živković, Nikica Živković, Tomislav Župić, Damir Hodžić, Vjekoslav Mandić, Slavko Orešković
Episiotomy is obstetric procedure during which the incision extends the vestibule of the vagina during the second stage of labor. Episiotomy was extensively spread with gradual increase of rates in the first half of the 20th century and was performed medio-laterally in all nulliparous women with the idea to protect fetal head from trauma and pelvic floor from injuries. However, reports claiming that episiotomy had no such benefits were published. It was shown that routine medio-lateral episiotomy did not protect against the appearance of urinary incontinence after vaginal delivery, while the risk of anal incontinence could be increased...
December 2016: Acta Clinica Croatica
https://www.readbyqxmd.com/read/29117085/do-intra-anal-bowel-management-devices-reduce-incontinence-associated-dermatitis-and-or-pressure-injuries
#5
Terrie Beeson, Bethany Eifrid, Caitlin A Pike, Joyce Pittman
PURPOSE: The purpose of this article was to examine the evidence and provide recommendations related to the effectiveness of intra-anal bowel management systems including intra-anal bowel catheters and rectal trumpets in reducing incontinence-associated dermatitis and pressure injuries. QUESTION: Does the use of an intra-anal bowel management system (intra-anal bowel catheter or rectal trumpet) reduce incontinence-associated skin damage and/or hospital-acquired pressure injuries in the acute care adult patient population? SEARCH STRATEGY: A search of the literature was performed by a trained university librarian, which resulted in 133 articles that examined intra-anal bowel management systems (intra-anal bowel catheter and rectal trumpet), incontinence-associated dermatitis, and pressure injuries...
November 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/29115980/anal-incontinence-and-quality-of-life-following-operative-treatment-of-simple-cryptoglandular-fistula-in-ano-a-prospective-study
#6
Umesh Jayarajah, Dakshitha Praneeth Wickramasinghe, Dharmabandhu Nandadeva Samarasekera
BACKGROUND: Anal incontinence is a known complication following operative treatment of fistula-in-ano which can significantly impact the quality of life. This study was aimed to objectively assess the impact of operative treatment of simple fistula-in-ano on quality of life related to anal incontinence. Therefore, a prospective study was conducted in 34 patients who underwent surgery for fistula-in-ano over a period of 24 months. Quality of life and incontinence were assessed using fecal incontinence quality of life (FIQL) scale and Cleveland clinic incontinence score (CCIS) preoperatively and after a minimum of 12 months follow up (mean-27 months, range 12-40 months)...
November 7, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/29094029/novel-anal-sphincter-saving-procedure-with-partial-excision-of-levator-ani-muscle-in-rectal-cancer-invading-ipsilateral-pelvic-floor
#7
Gyoung Tae Noh, Jeonghee Han, Chinock Cheong, Yoon Dae Han, Nam Kyu Kim
Purpose: Tumors at the level of the anorectal junction had required total levator-ani muscle excision to achieve an adequate resection margin. However, in the cases of tumor invading ipsilateral levator-ani muscle and intact external sphincter, en bloc resection of rectum with levator-ani muscle including tumor would be possible. This hemilevator excision (HLE) technique enables preserving the anal sphincter function while obtaining oncologic clearance and avoiding permanent colostomy in those patients...
October 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/29080959/short-term-efficacy-and-safety-of-three-novel-sphincter-sparing-techniques-for-anal-fistulae-a-systematic-review
#8
REVIEW
S O Adegbola, K Sahnan, G Pellino, P J Tozer, A Hart, R K S Phillips, J Warusavitarne, O D Faiz
BACKGROUND: The surgical treatment of complex anal fistulae, particularly those involving a significant portion of the anal sphincter in which fistulotomy would compromise continence, is challenging. Video-assisted anal fistula treatment (VAAFT), fistula tract laser closure (FiLaC™) and over-the-scope clip (OTSC(®)) proctology system are all novel sphincter-sparing techniques targeted at healing anal fistulae. In this study, all published articles on these techniques were reviewed to determine efficacy, feasibility and safety...
October 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/29080958/high-dose-versus-low-dose-botulinum-toxin-in-anal-fissure-disease
#9
P Ravindran, D L Chan, C Ciampa, R George, G Punch, S I White
BACKGROUND: There is no consensus on the optimal dosage of botulinum toxin (BT) as a sphincter sparing alternative to lateral internal sphincterotomy for chronic anal fissure. The aim of this study was to assess the long-term efficacy of high-dose BT as well as the presence of incontinence following the treatment of chronic anal fissure at a single institution. METHODS: A retrospective case-control study was performed at a single institution over a 6-year period (2009-2014)...
October 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/29076452/-treatment-of-anal-fissures
#10
Nina Sonne Bundgaard, Kikke Kirsten Hagen, Andreas Nordholm-Carstensen
Anal fissure is a common ailment, however, the pathophysiology and optimal treatment strategy is unclear. Anal fissures may be classified as acute or chronic. Acute fissures are effectively treated and prevented with conservative measures, whereas chronic fissures typically require medical or surgical therapy. Invasive interventions have superior healing rates compared with local medical therapies, but may cause persistent incontinence. New interventions are constantly introduced and may be of value in patients with high risk of incontinence, but more evidence is currently needed...
October 23, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/29071395/-25%C3%A2-years-of-integral-theory-by-petros-what-remains-and-what-s-next
#11
REVIEW
A Gunnemann, B Liedl, K Goeschen
BACKGROUND: The Integral Theory (IT) states that urinary stress and urge symptoms mainly arise from lax suspensory ligaments, which are a consequence of altered collagen/elastin. Four important muscle groups (pubococcygeal muscle, levatorplate, longitudinal muscle of the anus, and the puborectalis muscle) are only able to guarantee the opening and closure mechanism of the bladder, the urethra and the anal tube if the suspensory ligaments are intact. The first practical application of the IT was the repair of the pubourethral ligament (PUL) known as tension-free vaginal tape (TVT)...
October 25, 2017: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/29046273/upright-versus-lying-down-position-in-second-stage-of-labour-in-nulliparous-women-with-low-dose-epidural-bumpes-randomised-controlled-trial
#12
RANDOMIZED CONTROLLED TRIAL
(no author information available yet)
Objective To determine whether being upright in the second stage of labour in nulliparous women with a low dose epidural increases the chance of spontaneous vaginal birth compared with lying down.Design Multicentre pragmatic individually randomised controlled trial.Setting 41 UK hospital labour wards.Participants 3093 nulliparous women aged 16 or older, at term with a singleton cephalic presentation and in the second stage of labour with epidural analgesia.Interventions Women were allocated to an upright or lying down position, using a secure web based randomisation service, stratified by centre, with no masking of participants or clinicians to the trial interventions...
October 18, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29022787/does-a-missed-obstetric-anal-sphincter-injury-at-time-of-delivery-affect-short-term-functional-outcome
#13
L Ramage, C Yen, S Qiu, C Simillis, C Kontovounisios, E Tan, P Tekkis
Introduction This study aimed to ascertain whether missed obstetric anal sphincter injury at delivery had worse functional and quality of life outcomes than primary repair immediately following delivery. Materials and methods Two to one propensity matching was undertaken of patients presenting to a tertiary pelvic floor unit with ultrasound evidence of missed obstetric anal sphincter injury within 24 months of delivery with patients who underwent primary repair at the time of delivery by parity, grade of injury and time to assessment...
September 15, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28979889/comparative-analysis-of-efficacy-toxicity-and-patient-reported-outcomes-in-rectal-cancer-patients-undergoing-preoperative-3d-conformal-radiotherapy-or-vmat
#14
Antonia Regnier, Jana Ulbrich, Stefan Münch, Markus Oechsner, Dirk Wilhelm, Stephanie E Combs, Daniel Habermehl
BACKGROUND: Locally advanced rectal cancer (LARC) patients are usually treated within a multimodal therapy regime, in which the tumor resection plays the major role. This treatment ideally includes 5-fluorouracile (5FU)-based chemoradiation (CRT) leading to significantly improved local control rates. Local therapy as radiotherapy (RT) is required to be adapted referring to side effects and efficacy. Purpose of this study is the comparison of dosimetric parameters, acute and late toxicity, and quality of life in terms of patient-reported outcome (PRO) in patients treated with VMAT or 3D conformal radiotherapy (3DCRT) for LARC...
2017: Frontiers in Oncology
https://www.readbyqxmd.com/read/28969732/delayed-reconstruction-of-a-traumatic-cloaca-following-obstetric-anal-sphincter-rupture
#15
Ali Ezer, Alper Parlakgumus
Permanent communication between the rectum and the vagina along with full thickness of anal sphincter faults can be a result of an unsuccessful primary repair of fourth degree obstetric trauma. This results into complete fecal incontinence and impaired quality of life. Anterior overlapping sphincteroplasty can be chosen as a method of treatment for fecal incontinence due to obstetric injuries. However, large perineal body reconstructions are generally pretty challenging tasks for surgeons. What we will describe here for the repair of a traumatic cloaca, occurred 23 years ago during vaginal delivery, is the use of a transpositional flap following overlapping sphincteroplasty...
September 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28961836/late-toxicities-and-clinical-outcome-at-5%C3%A2-years-of-the-accord-12-0405-prodige-02-trial-comparing-two-neoadjuvant-chemoradiotherapy-regimens-for-intermediate-risk-rectal-cancer
#16
D Azria, J Doyen, M Jarlier, I Martel-Lafay, C Hennequin, P Etienne, V Vendrely, E François, G de La Roche, O Bouché, X Mirabel, B Denis, L Mineur, J Berdah, M Mahé, Y Bécouarn, O Dupuis, G Lledo, J Seitz, L Bedenne, S Gourgou-Bourgade, B Juzyna, T Conroy, J Gérard
Background: Outcome of intermediate risk rectal cancer may be improved by the addition of oxaliplatin during 5-fluoruracil concomitant neoadjuvant chemoradiotherapy. The purpose of this study is to analyze the main clinical results of the ACCORD12 trial (NCT00227747) in rectal cancer after 5 years of follow-up. Patients and methods: Inclusion criteria were as follows: rectal adenocarcinoma accessible to digital examination staged T3-T4 Nx M0 (or T2 Nx distal anterior rectum)...
October 1, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28950040/fecal-incontinence-in-patients-with-spina-bifida-the-target-is-the-rectum
#17
Charlène Brochard, Alain Ropert, Benoît Peyronnet, Hélène Ménard, Andréa Manunta, Michel Neunlist, Guillaume Bouguen, Laurent Siproudhis
AIMS: The prevalence rate of severe fecal incontinence (FI) in adults with spina bifida (SB) is high. The physiological basis of FI in SB has not been clearly established, which contributes to inadequate care. The aim was to better characterize a large cohort of adults with special consideration of anorectal physiology. METHODS: A multidisciplinary team from a French referral centre for SB prospectively collected data on patients who had an anorectal manometry. Factors associated with severe FI (Cleveland clinical incontinence score ≥ 9) were assessed in a multivariate analysis model...
September 26, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28944332/the-whitehead-operation-procedure-is-it-a-useful-technique
#18
Kenan Erzurumlu, Kağan Karabulut, Gökhan Selçuk Özbalcı, İsmail Alper Tarım, Gökhan Lap, Bülent Güngör
OBJECTIVE: Hemorrhoidal disease is a very common entity in the general population; however, the therapeutic approaches to hemorrhoids remain controversial. The choice of treatment method depends on the grade of the hemorrhoid as well as the experience of the surgeon. The Whitehead hemorrhoidectomy procedure is often applied for grade IV hemorrhoids. MATERIAL AND METHODS: We studied 49 patients who underwent surgery between December 1982 and January 2013. The indications for the Whitehead procedure in all patients were grade IV hemorrhoidal disease...
2017: Turk J Surg
https://www.readbyqxmd.com/read/28943921/safety-and-feasibility-of-laparoscopic-intersphincteric-resection-for-a-lower-rectal-tumor
#19
Nobuhisa Matsuhashi, Takao Takahashi, Toshiyuki Tanahashi, Satoshi Matsui, Hisashi Imai, Yoshihiro Tanaka, Kazuya Yamaguchi, Shinji Osada, Kazuhiro Yoshida
The aim of the present study was to evaluate the short-term surgical outcomes of laparoscopic intersphincteric resection (ISR) for a lower rectal tumor in comparison with a case-control series of patients undergoing open ISR. Quality of life factors and anal function were also evaluated. Between July 2008 and April 2013, 103 patients with lower rectal cancer underwent laparoscopic surgery at the Surgical Oncology Department of Gifu University School of Medicine. A total of 25 patients with lower rectal cancer underwent ISR, and 19/25 patients who underwent laparoscopic ISR were compared with the control group of 6 patients who underwent open ISR...
October 2017: Oncology Letters
https://www.readbyqxmd.com/read/28941931/the-anal-canal-is-the-fine-line-between-fecal-incontinence-and-colitis-after-a-pull-through-for-hirschsprung-disease
#20
Luis De la Torre, Kimberly Cogley, Karla Santos, Otto Morales, Juan Calisto
BACKGROUND/PURPOSE: Fecal incontinence after a pull-through is associated with different factors, although damage to the anal canal seems to be the most important. The objective of this article is to identify the variables related to the presence of fecal control and colitis in a homogeneous group of children after pull-through. METHODS: A retrospective cross-sectional study was performed in patients with HD for evaluation of post-operative problems from May 2014 to November 2016...
September 4, 2017: Journal of Pediatric Surgery
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