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Pelvic floor, prolapse, fecal incontinence, constipation

José Ananias Vasconcelos Neto, Camila Teixeira Moreira Vasconcelos, Sthela Maria Murad Regadas, Leonardo Robson Pinheiro Sobreira Bezerra, Kathiane Augusto Lustosa, Sara Arcanjo Lino Karbage
INTRODUCTION AND HYPOTHESIS: The aim of this study was to evaluate the correlations between the POP-Q Bp point and the perineal body (Pb) and genital hiatus (Gh) measurements and constipation, anal incontinence, severity of symptoms and quality of life. METHODS: The patients were distributed into two groups according to the posterior vaginal wall Bp point: one group with Bp ≤-1 (without posterior vaginal wall prolapse, control group) and the other group with Bp ≥0 (with posterior vaginal wall prolapse, case group)...
March 6, 2017: International Urogynecology Journal
Kyla Joubert, Jonathan A Laryea
Rectal prolapse is a debilitating condition with a complex etiology. Symptoms are most commonly prolapse of the rectum and pain with bowel movements or straining, with worsening fecal incontinence over time due to progressive stretching of the anal sphincters. Physical findings are fairly consistent from patient to patient-most notably diastasis of the levator ani muscles, deep pouch of Douglas, redundant sigmoid colon, a mobile mesorectum, and occasionally a solitary rectal ulcer. Evaluation includes a physical exam or imaging demonstrating the prolapse, and evaluating for other causes of pelvic floor dysfunction...
February 2017: Clinics in Colon and Rectal Surgery
Jan J van Iersel, Chris J de Witte, Paul M Verheijen, Ivo A M J Broeders, Egbert Lenters, Esther C J Consten, Steven E Schraffordt Koops
BACKGROUND: Pelvic floor disorders are a major public health issue. For female genital prolapse, sacrocolpopexy is the gold standard. Laparoscopic ventral mesh rectopexy is a relatively new and promising technique correcting rectal prolapse. There is no literature combining the 2 robotically assisted techniques. OBJECTIVE: This study was designed to evaluate the safety, quality of life, and functional and sexual outcomes of robot-assisted sacrocolporectopexy for multicompartment prolapse of the pelvic floor...
October 2016: Diseases of the Colon and Rectum
Thomas Frieling
Fecal incontinence is defined by the unintentional loss of solid or liquid stool, and anal incontinence includes leakage of gas and / or fecal incontinence. Anal-fecal incontinence is not a diagnosis but a symptom. Many patients hide the problem from their families, friends, and even their doctors. Epidemiologic studies indicate a prevalence between 7-15 %, up to 30 % in hospitals and up to 70 % in longterm care settings. Anal-fecal incontinence causes a significant socio-economic burden. There is no widely accepted approach for classifying anal-fecal incontinence available...
August 2016: Deutsche Medizinische Wochenschrift
Sumerova Natalia, Neuman Menahem, Krissi Haim, Pushkar Dmitri
OBJECTIVES: To evaluate the feasibility, safety and surgical results of skeletonized mesh implants to form a pelvic harness for pelvic floor reconstruction surgery. STUDY DESIGN: Patients with advanced pelvic floor prolapse were enrolled to this study. Study model was a kit mesh, reduced to 75% of the original surface area by cutting out mesh material from the central mesh body. Patients were evaluated at the end of the 1st and 6th post-operative months and interviewed at the study conclusion...
May 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Uduak U Andy, Heidi S Harvie, Avita P Pahwa, Alayne Markland, Lily A Arya
AIMS: To determine if fecal incontinence (FI) is associated with constipation and defecatory symptoms in women with urinary incontinence, fecal incontinence, and pelvic organ prolapse. METHODS: Cross-sectional study of women seeking care for urinary incontinence, fecal incontinence, and pelvic organ prolapse. FI was defined as a positive response to the question, "During the last 4 weeks how often have you leaked or soiled yourself with stool?" Constipation and defecatory symptoms, including straining, sensation of incomplete emptying, and splinting, were measured using the Birmingham Bowel Symptom Questionnaire and the Colorectal Anal Distress Inventory...
February 2017: Neurourology and Urodynamics
Liliana Bordeianou, Caitlin W Hicks, Adriana Olariu, Lieba Savitt, Samantha J Pulliam, Milena Weinstein, Todd Rockwood, Patricia Sylla, James Kuo, May Wakamatsu
BACKGROUND: The association between an objective measure of fecal incontinence severity and patient-reported quality of life is poorly understood. OBJECTIVE: The purpose of this study was to evaluate patients with various degrees of fecal incontinence to determine whether their quality of life as measured by the Fecal Incontinence Quality of Life Scale is affected by coexisting pelvic floor disorders. DESIGN: This was a prospective, survey-based study...
November 2015: Diseases of the Colon and Rectum
Desiree M J Vrijens, Jolanda I Spakman, Gommert A van Koeveringe, Bary Berghmans
OBJECTIVES: To assess patient-reported outcome and satisfaction regarding urinary incontinence 1 year after the end of treatment in a multidisciplinary pelvic care clinic. METHODS: A total of 647 patients with urinary incontinence seen in an academic multidisciplinary pelvic care clinic were prospectively included in a specific triage system. Patient-reported improvement of urinary incontinence and patient satisfaction were assessed by telephone survey 1 year after the end of treatment...
November 2015: International Journal of Urology: Official Journal of the Japanese Urological Association
Marc Beer-Gabel, Dan Carter
INTRODUCTION: X-ray defecography is considered the gold standard for imaging pelvic floor pathology. However, it is limited by the capability to demonstrate only the posterior pelvic compartment, significant radiation exposure, and inconvenience. Dynamic transperineal ultrasound (DTP-US) can visualize all of three pelvic floor compartments, is free of radiation, and does not cause significant discomfort. The aim of this study was to evaluate the level of consistency between defecography (DEF) and DTP-US in the diagnosis of pelvic floor deformations...
June 2015: International Journal of Colorectal Disease
Bary Berghmans, Fred Nieman, C Leue, M Weemhoff, S Breukink, G van Koeveringe
AIMS: (i) To describe and analyse pelvic floor dysfunction symptoms in women referred to a Pelvic Care Centre (PCC). (ii) To describe the triage process of the same patients based on response to a first-contact interview. METHODS: Triage started with a telephone interview using previously constructed questions, asking for seven types of PF complaints during the preceding 6 months. If present, complaint severity was registered on a 0-10 scale. Next, these first-contact complaints were used to describe patient case mix profiles using cross-tabular analysis...
April 2016: Neurourology and Urodynamics
Suzanne M Mugie, D Gregory Bates, Jaya B Punati, Marc A Benninga, Carlo Di Lorenzo, Hayat M Mousa
BACKGROUND: Defecography is a study to assess anorectal function during evacuation. OBJECTIVE: To investigate the value of fluoroscopic defecography in directing diagnostic and therapeutic management in children with defecation disorders. MATERIALS AND METHODS: We reviewed all fluoroscopic defecography studies performed (2003-2009) in children with defecation problems and normal anorectal motility studies. Results were classified into three groups: (1) normal pelvic floor function; (2) pelvic floor dyssynergia, including incomplete relaxation of pelvic musculature, inconsistent change in anorectal angle and incomplete voluntary evacuation; (3) structural abnormality, including excessive pelvic floor descent with an intra-rectal intussusception, rectocele or rectal prolapse...
February 2015: Pediatric Radiology
Laura García del Salto, Jaime de Miguel Criado, Luis Felipe Aguilera del Hoyo, Leticia Gutiérrez Velasco, Patricia Fraga Rivas, Marcos Manzano Paradela, María Isabel Díez Pérez de las Vacas, Ana Gloria Marco Sanz, Eduardo Fraile Moreno
Pelvic floor weakness is a functional condition that affects the anatomic structures supporting the pelvic organs: fasciae, ligaments, and muscles. It is a prevalent disorder among people older than 50 years, especially women, and may substantially diminish their quality of life. Many complex causes of pelvic floor weakness have been described, but the greatest risk factors are aging and female sex. Pelvic floor weakness can provoke a wide range of symptoms, including pain, urinary and fecal incontinence, constipation, difficulty in voiding, a sense of pressure, and sexual dysfunction...
September 2014: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Leonardo Robson Pinheiro Sobreira Bezerra, José Ananias Vasconcelos Neto, Camila Teixeira Moreira Vasconcelos, Sara Arcanjo Lino Karbage, Amene Cidrão Lima, Isabella Parente Ribeiro Frota, Adriana Bombonato de Oliveira Rocha, Sandra Rebouças Macedo, Cassia Fernandes Coelho, Marília Karla Nunes Costa, Geisele Cavalcante de Souza, Sthela Murad Regadas, Kathiane Lustosa Augusto
INTRODUCTION AND HYPOTHESIS: Little information is available on the recurrent coexistence of pelvic organ prolapse (POP), urinary (UI) and/or anal (AI) incontinence and defecatory dysfunctions and the relationship between these disorders. The purpose of this study is to report the prevalence, bother, and impact on quality of life (QoL) of unreported bowel symptoms in women presenting to a Brazilian tertiary urogynecology clinic. METHODS: The study was a cross-section survey of 172 patients with symptoms of pelvic floor disorders (PFD)...
July 2014: International Urogynecology Journal
Neuman Menahem, Neuman Meuman, Sumerova Natalia, Sosnovski Vladimir, Bornstein Jacob
OBJECTIVE: To evaluate whether anterior-apical compartment mesh implants for pelvic floor reconstruction might be safely and effectively anchored to the sacro-spinous (SS) ligaments instead of the arcus tendineus fascia pelvis (ATFP). The SS ligaments as anchoring structures for centro-apical support mesh fixation are thought to be stronger than the ATFP and we presumed that anterior mesh fixation to the SS ligament might be feasible, safe and effective. STUDY DESIGN: Patients with advanced anterior-apical pelvic floor prolapse, referred for mesh reconstruction and having poor ATFP were enrolled to this study...
January 2014: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Yusuke Watadani, Sarah A Vogler, Jeffrey S Warshaw, Taijiro Sueda, Ann C Lowry, Robert D Madoff, Anders Mellgren
BACKGROUND: Sacrocolpopexy with rectopexy is advocated for combined rectal and vaginal prolapse, but limited outcome data have been reported. OBJECTIVE: The purpose of this study was to evaluate the indications and outcomes of sacrocolpopexy and rectopexy by comparing pre- and postoperative function and quality of life. DESIGN: A retrospective review of prospectively collected data was performed of all patients undergoing sacrocolpopexy and rectopexy at our institution from 2004 to 2011...
December 2013: Diseases of the Colon and Rectum
S Adusumilli, M P Gosselink, S Fourie, K Curran, O M Jones, C Cunningham, I Lindsey
AIM: Pelvic floor retraining is considered first-line treatment for patients with faecal incontinence or obstructed defaecation. There are at present no data on the effect of a high grade internal rectal prolapse on outcomes of pelvic floor retraining. The current study aimed to assess this influence. METHOD: In all, 120 consecutive patients were offered pelvic floor retraining. The predominant symptom was faecal incontinence in 56 patients (47%) and obstructed defaecation in 64 patients (53%)...
November 2013: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Werner Kneist, Daniel W Kauff, Gert Naumann, Hauke Lang
PURPOSE: Nerve sparing in functional pelvic floor surgery is strongly recommended as intraoperative damage to the autonomic nerves may predispose to persistent or worsened anorectal and urogenital function. The aim of this study was to investigate the intraoperative neural topography above the pelvic floor in patients undergoing laparoscopic resection rectopexy in combination with electrophysiologic neuromapping. METHODS: Ten consecutive female patients underwent laparoscopic resection rectopexy for rectal prolapse...
April 2013: Langenbeck's Archives of Surgery
Christl Reisenauer, Volker Viereck
Diagnoses of complications in women who underwent pelvic floor surgery using meshes and the multidisciplinary management of these cases at two national referral urogynecological centers between January and June 2011 are presented in a series of cases of mesh complications, which provide an indication of the wide range of symptoms and, at times, the long time span over which they may be encountered. Complications included infection, erosion (extrusion/exposure), fistulas, perforation into the surrounding organs (such as urethra, bladder and/or bowel), chronic pelvic pain (often radiating into buttocks, groins and/or thighs), dysuria, dyschezia, voiding difficulties, constipation, stool evacuation difficulties, de novo overactive bladder, urinary and fecal incontinence and prolapse recurrences...
July 2012: Acta Obstetricia et Gynecologica Scandinavica
Guri Rortveit, Leslee L Subak, David H Thom, Jennifer M Creasman, Eric Vittinghoff, Stephen K Van Den Eeden, Jeanette S Brown
OBJECTIVES: : We investigated the prevalence of and risk factors for combinations of urinary incontinence (UI), fecal incontinence (FI) and pelvic organ prolapse (POP) in racially diverse women older than 40 years. METHODS: : The Reproductive Risks for Incontinence Study at Kaiser is a population-based study with data from 2106 women older than 40 years. Pelvic floor conditions were determined by self-report. Risk factors were assessed by self-report, interview and record review...
September 2010: Female Pelvic Medicine & Reconstructive Surgery
Daniel J Kaser, Erron L Kinsler, Todd A Mackenzie, Paul Hanissian, Kris Strohbehn, James L Whiteside
INTRODUCTION AND HYPOTHESIS: The optimal surgery for combined apical and posterior vaginal prolapse is not well defined. Our objective was to examine the anatomic and functional outcomes following sacrocolpopexy (SCP) with or without posterior colporrhaphy (PC). METHODS: We retrospectively evaluated 258 women who underwent abdominal (n = 62) or laparoscopic (n = 196) SCP with or without PC. Preoperative anatomic support and standardized bowel symptoms were compared to 6-week and 1-year postoperative values, using Student's t test and Wilcoxon rank sum test, respectively...
September 2012: International Urogynecology Journal
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