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Sphincter tear

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https://www.readbyqxmd.com/read/28239456/chronic-anal-fissures-open-lateral-internal-sphincterotomy-result-a-case-series-study
#1
Abdulwahid M Salih
INTRODUCTION: Anal fissure are defined as a tear in the skin of the anal canal distal to dentate line. Although still there are controversies about the exact management, lateral sphincterotomy is promising. The aim of this series is to present the outcome of lateral sphincterotomy for internal anal sphincter in term of patient satisfaction and complication. PATIENT AND METHODS: A prospective single cohort study, 190 patients, who were undergone lateral sphincterotomy for internal anal sphincter from 2010 to 2014, were analyzed...
March 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28207499/laparoscopic-heller-myotomy-is-not-superior-to-pneumatic-dilation-in-the-management-of-primary-achalasia-conclusions-of-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#2
REVIEW
Ji-Wei Cheng, Yin Li, Wen-Qun Xing, Hong-Wei Lv, Hao-Ran Wang
BACKGROUND: Achalasia is an esophageal motility disorder, of unknown cause, which results in increased lower esophageal sphincter tone and symptoms of difficulty swallowing. Current major therapeutic options include laparoscopic Heller myotomy (LHM) and pneumatic dilation (PD). We undertake a systematic review comparing the efficacy and safety of these 2 treatments in the treatment of esophageal achalasia. METHODS: PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched for randomized controlled trial investigating LHM versus PD in the treatment of primary achalasia...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28159134/routine-interventions-in-childbirth-before-and-after-initiation-of-an-action-research-project
#3
Viola Nyman, Leyla Roshani, Marie Berg, Terese Bondas, Soo Downe, Anna Dencker
BACKGROUND: Unnecessary routine interventions in uncomplicated labour and birth, like cardiotocography (CTG), amniotomy, use of scalp electrode and oxytocin treatment, are associated with further interventions that could harm the woman and the infant. A four year Action Research (AR) project was done on a labour ward to enhance the capacity of local midwives in the promotion of physiological labour and birth. AIM: To describe the use of interventions during labour and birth in healthy women at term with spontaneous onset of labour, before and after initiation of an Action Research project...
March 2017: Sexual & Reproductive Healthcare: Official Journal of the Swedish Association of Midwives
https://www.readbyqxmd.com/read/28117880/intrapartum-predictors-of-maternal-levator-ani-injury
#4
Jessica Caudwell-Hall, Ixora Kamisan Atan, Andrew Martin, Rodrigo Guzman Rojas, Susanne Langer, Kalai Shek, Hans Peter Dietz
INTRODUCTION: Damage to the pelvic floor during vaginal childbirth is common, and may take the form of levator avulsion or irreversible over-distention of the levator hiatus (microtrauma). Such trauma is a major risk factor for pelvic organ prolapse later in life. In this study we aimed to identify intrapartum risk factors for levator trauma. MATERIAL AND METHODS: This is a retrospective analysis of data obtained in two perinatal studies on primiparous women. Between 2005 and 2014, 1148 patients carrying an uncomplicated singleton pregnancy in the late third trimester were seen for 4D pelvic floor ultrasound and an interview...
January 24, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28027700/management-of-persistent-occiput-posterior-position-a-substantial-role-of-instrumental-rotation-in-the-setting-of-failed-manual-rotation
#5
Paul Guerby, Mickael Allouche, Caroline Simon-Toulza, Christophe Vayssiere, Olivier Parant, Fabien Vidal
INTRODUCTION: To compare the maternal and neonatal outcomes associated with Instrumental Rotation (IR) to operative vaginal delivery in occiput posterior (OP) position with Thierry's spatulas (TS), in the setting of failed manual rotation (MR). STUDY DESIGN: We led a prospective observational cohort study in a tertiary referral hospital in Toulouse, France. All women presenting in labor with persistent OP position at full cervical dilatation and who delivered vaginally after failed MR and with IR or OP assisted delivery were included from January 2014 to December 2015...
January 23, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28027607/third-or-fourth-degree-intrapartum-anal-sphincter-tears-are-associated-with-levator-ani-avulsion-in-primiparas
#6
Dan V Valsky, Sarah M Cohen, Michal Lipschuetz, Drorith Hochner-Celnikier, Hagit Daum, Itai Yagel, Simcha Yagel
OBJECTIVES: We evaluated primiparous women with clinically diagnosed third- and fourth-degree and anal sphincter tears, to evaluate the rate of levator ani muscle injury compared to primiparous women without sphincter tears. METHODS: Primiparous women delivering in our maternity ward with intrapartum diagnoses of third- or fourth-degree anal sphincter tears, repaired by the overlapping technique, were recruited to undergo 3-dimensional transperineal sonography of the pelvic floor anatomy, including the anterior and posterior compartments...
April 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/27986182/episiotomy-technique-and-management-of-anal-sphincter-tears-a-survey-of-clinical-practice-and-education
#7
Rebecca Menzies, Marian Leung, Nirmala Chandrasekaran, Andrea Lausman, Michael Geary
OBJECTIVE: To ascertain current techniques of episiotomy used by obstetrics and gynaecology faculty members and residents in an academic department and to determine the current management strategies for third and fourth degree tears. METHOD: A 14-question anonymous online survey was circulated to all faculty members and residents in the University of Toronto Department of Obstetrics and Gynaecology between October 2015 and March 2016. Results were analyzed descriptively or with Fisher exact test...
December 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/27918340/obstetrical-anal-sphincter-injuries-does-obstetrical-care-provider-matter-a-quality-assurance-study-in-ontario
#8
Katerina Pizzuto, Jessica Pudwell, Graeme N Smith, Marie-Andrée Harvey
OBJECTIVES: We sought to determine the rates of obstetrical anal sphincter tears (OASIS) between types of obstetrical care providers at Kingston General Hospital (KGH) and in Ontario via the Better Outcomes Registry Network (BORN). METHODS: This cross-sectional study collected patient, demographic, and delivery data from all vaginal deliveries at KGH from June 2011 to June 2014 and all vaginal deliveries through the BORN database from June 2012 to June 2014. RESULTS: During this period, 4...
December 1, 2016: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/27865290/pneumatic-dilation-of-the-lower-esophageal-sphincter-can-now-be-successfully-performed-without-morbidity
#9
Yi Jia, Marco Bustamante, Sharareh Moraveji, Richard W McCallum
BACKGROUND: Patients with dysphagia may be diagnosed with impaired lower esophageal sphincter (LES) relaxation and treated with pneumatic dilation (PD), stretching and tearing LES muscle fibers. Esophageal perforation has been reported to be as high as 10%. We conducted a retrospective study to evaluate the perforation rate of PD when used for impaired relaxation of the LES using current techniques. METHODS: A chart review was conducted to identify patients referred for esophageal manometry by high-resolution manometry and later received PD from January 2013 to April 2016...
November 2016: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/27859542/midwives-management-during-the-second-stage-of-labor-in-relation-to-second-degree-tears-an-experimental-study
#10
Malin Edqvist, Ingegerd Hildingsson, Margareta Mollberg, Ingela Lundgren, Helena Lindgren
INTRODUCTION: Most women who give birth for the first time experience some form of perineal trauma. Second-degree tears contribute to long-term consequences for women and are a risk factor for occult anal sphincter injuries. The objective of this study was to evaluate a multifaceted midwifery intervention designed to reduce second-degree tears among primiparous women. METHODS: An experimental cohort study where a multifaceted intervention consisting of 1) spontaneous pushing, 2) all birth positions with flexibility in the sacro-iliac joints, and 3) a two-step head-to-body delivery was compared with standard care...
March 2017: Birth
https://www.readbyqxmd.com/read/27761586/reducing-obstetric-anal-sphincter-injuries-using-perineal-support-our-preliminary-experience
#11
Madhu Naidu, Abdul H Sultan, Ranee Thakar
INTRODUCTION AND HYPOTHESIS: Obstetric anal sphincter injuries (OASIs) are associated with significant short-term and long-term morbidity. Over the past decade, there has been a steady rise in the rate of OASIs. There is therefore a compelling need to identify strategies to minimize OASIs. The objective of this study was to determine if perineal support at the time of vaginal delivery can reduce the incidence and severity of OASIs. METHODS: All labour ward staff including midwives and doctors were invited to train in the technique of perineal support during vaginal delivery...
March 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/27724946/episiotomy-and-obstetric-outcomes-among-women-living-with-type-3-female-genital-mutilation-a-secondary-analysis
#12
Maria I Rodriguez, Armando Seuc, Lale Say, Michelle J Hindin
BACKGROUND: To investigate the association between type of episiotomy and obstetric outcomes among 6,187 women with type 3 Female Genital Mutilation (FGM). METHODS: We conducted a secondary analysis of women presenting in labor to 28 obstetric centres in Burkina Faso, Ghana, Kenya, Nigeria, Senegal and Sudan between November 2001 and March 2003. Data were analysed using cross tabulations and multivariable logistic regression to determine if type of episiotomy by FGM classification had a significant impact on key maternal outcomes...
October 10, 2016: Reproductive Health
https://www.readbyqxmd.com/read/27720515/-assessment-of-restrictive-episiotomy-use-and-impact-on-perineal-tears-in-the-burgundy-s-perinatal-network
#13
P Ginod, B Khallouk, E Benzenine, T Desplanches, T Dub, E Schmutz, S Douvier, P Sagot
OBJECTIVES: To analyse episiotomy and perineal tears rates in Burgundy after French National College of Obstetricians and Gynecologists (CNGOF) guidelines in 2005. MATERIALS AND METHOD: Multicenter retrospective study, between 2003-2005 (period 1) et 2012-2014 (period 2), conducted on singletons vaginal deliveries, in cephalic presentation from 37 weeks. We compared the episiotomy rate (ER), and perineal lesions in normal deliveries (ND) and instrumental deliveries (ID) between the two periods...
November 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/27643513/over-diagnosis-and-rising-rates-of-obstetric-anal-sphincter-injuries-oasis-time-for-reappraisal
#14
Dimos Sioutis, Ranee Thakar, Abdul H Sultan
OBJECTIVES: To identify the accuracy of clinically diagnosed OASIS using 3D endoanal ultrasound and compare symptoms and anal manometry measurements between those whose anal sphincters were adequately repaired to those who had persistent anal sphincter defects. METHODS: The endoanal scan images of women who sustained OASIS and attended the perineal clinic over a 10 year period (2003 - 2013) were re-analysed from data entered prospectively of women with clinically diagnosed and repaired OASIS...
September 19, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27613623/residual-defects-after-repair-of-obstetric-anal-sphincter-injuries-and-pelvic-floor-muscle-strength-are-related-to-anal-incontinence-symptoms
#15
Cristina Ros Cerro, Eva Martínez Franco, Giulio Aniello Santoro, Maria José Palau, Pawel Wieczorek, Montserrat Espuña-Pons
INTRODUCTION AND HYPOTHESIS: The aim was to analyze the correlation between residual anal sphincter (AS) defects and pelvic floor muscle (PFM) strength on anal incontinence (AI) in patients with a history of obstetric AS injuries (OASIS). METHODS: From September 2012 to February 2015, an observational study was conducted on a cohort of females who underwent repair of OASIS intrapartum. The degree of OASIS was scored intrapartum according to Sultan's classification...
September 9, 2016: International Urogynecology Journal
https://www.readbyqxmd.com/read/27488319/is-endoscopic-papillary-large-balloon-dilation-safe-for-treating-large-cbd-stones
#16
REVIEW
Chan Sup Shim, Ji Wan Kim, Tae Yoon Lee, Young Koog Cheon
In recent years, endoscopic papillary large balloon dilation (EPLBD) with endoscopic sphincterotomy (EST) has been shown to be an effective technique for the removal of large or difficult common bile duct (CBD) stones, as an alternative to EST. Reviewing the literature published since 2003, it is understood that EPLBD has fewer associated overall complications than EST. Bleeding occurred less frequently with EPLBD than with EST. There was no significant difference in postendoscopic retrograde cholangiopancreatography pancreatitis or perforation...
July 2016: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
https://www.readbyqxmd.com/read/27454848/maternal-birth-trauma-why-should-it-matter-to-urogynaecologists
#17
Hans P Dietz, Peter D Wilson, Ian Milsom
PURPOSE OF REVIEW: There is increasing awareness of the importance of intrapartum events for future pelvic floor morbidity in women. In this review, we summarize recent evidence and potential consequences for clinical practice. RECENT FINDINGS: Both epidemiological evidence and data from perinatal imaging studies have greatly improved our understanding of the link between childbirth and later morbidity. The main consequences of traumatic childbirth are pelvic organ prolapse (POP) and anal incontinence...
October 2016: Current Opinion in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27274119/management-of-fourth-degree-obstetric-perineal-tear-without-colostomy-using-non-stimulated-gracilis-our-experience-over-eleven-years
#18
Jiten Kulkarni, Anuradha J Patil, Bhaskar Musande, Abhishek B Bhamare
BACKGROUND: Although gracilis muscle transposition for faecal incontinence has been well-described method, its literature for use in obstetric perineal tear without colostomy is sparse. In this study, we have tried to analyse its use in fourth-degree obstetric perineal tears. PATIENTS AND METHODS: A total of 30 patients with recto-vaginal fistula with faecal incontinence secondary to obstetric perineal tear were retrospectively studied between February 2003 and May 2014...
January 2016: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/27226734/the-effect-of-implementing-a-new-guideline-and-operative-pro-forma-on-the-detection-and-management-of-third-and-fourth-degree-perineal-tears
#19
Kristin Cornell, Alison De Souza, Mark Tacey, David M Long, Mayooran Veerasingham
BACKGROUND: Obstetric anal sphincter injury (OASI) is a serious complication of vaginal births, resulting in possible long-term consequences such as incontinence and pain. Adequate detection and management of these injuries is vital in minimizing the impact they have on women. AIM: To assess the rates of detection, management, and outcomes of OASI before and after the implementation of a new clinical practice guideline and operative pro forma. MATERIALS AND METHODS: A 12-month audit of the incidence, management, and outcomes of OASI was conducted in 2009...
2016: International Journal of Women's Health
https://www.readbyqxmd.com/read/27185318/sexual-activity-and-dyspareunia-the-first-year-postpartum-in-relation-to-degree-of-perineal-trauma
#20
Kathrine Fodstad, Anne Cathrine Staff, Katariina Laine
INTRODUCTION AND HYPOTHESIS: Knowledge on sexual complaints and time to sexual resumption after obstetric anal sphincter injury (OASI) is scarce. The aim of the study was to investigate self-reported sexual activity and coital problems 1 year postpartum in relation to perineal trauma, in addition to delivery mode. METHODS: Among 2,846 women recruited during pregnancy, all women who delivered with OASI (n = 42, all third-degree perineal tears), in addition to 20 randomly selected controls per OASI case, a total of 882 women, were sent a self-administered questionnaire addressing time to coital resumption after delivery and potential coital difficulty 1 year postpartum...
October 2016: International Urogynecology Journal
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