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Sphincter tear

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https://www.readbyqxmd.com/read/27918340/obstetrical-anal-sphincter-injuries-does-obstetrical-care-provider-matter-a-quality-assurance-study-in-ontario
#1
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
#2
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
#3
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...
November 14, 2016: Birth
https://www.readbyqxmd.com/read/27761586/reducing-obstetric-anal-sphincter-injuries-using-perineal-support-our-preliminary-experience
#4
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...
October 19, 2016: 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
#5
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
#6
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...
October 6, 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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/27164486/can-the-incidence-of-obstetric-anal-sphincter-injury-be-reduced-the-stomp-experience
#14
Maya Basu, Dot Smith, Robin Edwards
OBJECTIVE: To reduce the incidence of third and fourth degree perineal tears. STUDY DESIGN: This was a quality improvement project followed by an audit of outcomes. The population consisted of all women delivering vaginally over a 12 month period following implementation of the quality improvement measures. Following a review of clinical factors associated with all third and fourth degree tears over a 3 month period and a review of relevant evidence, a series of measures to try and reduce the incidence of such tears were introduced...
July 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27158423/current-applications-of-transperineal-ultrasound-in-gastroenterology
#15
REVIEW
Andreia Albuquerque, Eduardo Pereira
Transperineal ultrasound is an inexpensive, safe and painless technique that dynamically and non-invasively evaluates the anorectal area. It has multiple indications, mainly in urology, gynaecology, surgery and gastroenterology, with increased use in the last decade. It is performed with conventional probes, positioned directly above the anus, and may capture images of the anal canal, rectum, puborectalis muscle (posterior compartment), vagina, uterus, (central compartment), urethra and urinary bladder (anterior compartment)...
April 28, 2016: World Journal of Radiology
https://www.readbyqxmd.com/read/27139718/outcomes-following-surgical-repair-using-layered-closure-of-unrepaired-4th-degree-perineal-tear-in-rural-western-uganda
#16
Judith T W Goh, Stephanie B M Tan, Harriet Natukunda, Isaac Singasi, Hannah G Krause
INTRODUCTION: In many rural low-income countries, perineal tears at time of vaginal birth are not repaired at time of delivery. The aims of this study are to describe the surgical technique for management of the unrepaired 4th degree tear, performed without flaps, and short-term follow up on anal incontinence symptoms using a validated questionnaire. METHODS: Women presenting to fistula camps in western Uganda with unrepaired 4th degree tears were interviewed using the Cleveland Clinic Continence Score...
April 30, 2016: International Urogynecology Journal
https://www.readbyqxmd.com/read/27111342/savary-dilation-is-safe-and-effective-treatment-for-esophageal-narrowing-related-to-pediatric-eosinophilic-esophagitis
#17
Abdulrahman Al-Hussaini
OBJECTIVES: Data on management of esophageal narrowing related to eosinophilic esophagitis (EoE) in children are scanty. The aim of the present study is to assess the safety and effectiveness of esophageal dilation in pediatric EoE from the largest case series to date. METHODS: Children diagnosed with EoE during 2004 to 2015 were reviewed for the presence of esophageal narrowing. Esophageal narrowing was categorized as short segment narrow caliber, long segment narrow caliber, and single short stricture...
November 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/27100274/factors-predicting-a-failed-primary-repair-of-obstetric-anal-sphincter-injury
#18
Jaan Kirss, Tarja Pinta, Camilla Böckelman, Mikael Victorzon
INTRODUCTION: The success of the primary repair of obstetric anal sphincter injury (OASI) is paramount in maintaining adequate fecal continence after childbirth. The factors determining the success or failure of primary repair are unclear. The aim of this study is to investigate modifiable factors determining the success or failure of the primary sphincter repair after OASI. MATERIAL AND METHODS: Sixty women with OASI were investigated by endoanal ultrasound or magnetic resonance imaging, and with the Wexner incontinence questionnaire...
September 2016: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/27087312/postpartum-2d-and-3d-ultrasound-evaluation-of-the-anal-sphincter-complex-in-women-with-obstetric-anal-sphincter-injuries
#19
C Ros, E Martínez-Franco, M M Wozniak, J Cassado, G A Santoro, N Elías, M López, M Palacio, A P Wieczorek, M Espuña-Pons
OBJECTIVES: Endoanal ultrasound (EAUS) is the gold standard investigation of anal sphincter integrity. Aim of this study was to compare the sensitivity and specificity of 3D-EAUS with 2D and 3D transperineal US (TPUS), and 3D endovaginal US (EVUS) in detecting residual defects after primary repair of obstetric anal sphincter injuries (OASIS). METHODS: The external (EAS) and internal anal sphincters (IAS) were evaluated in women with OASIS by four ultrasound modalities...
March 22, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27018243/episiotomy-risk-factors-and-outcomes
#20
Anat Shmueli, Rinat Gabbay Benziv, Liran Hiersch, Eran Ashwal, Rami Aviram, Yariv Yogev, Amir Aviram
OBJECTIVE: To identify risk factors for mediolateral episiotomy, and evaluate the risk of obstetrical anal sphincter injury (OASI) among women with an episiotomy. METHODS: A retrospective cohort study of all singletons vaginal deliveries at term between 2007 and 2014. Spontaneous and operative vaginal deliveries were compared separately, as well as nulliparous and multiparous women. RESULTS: Overall, 41,347 women were included in the spontaneous vaginal delivery group: 12,585 (30...
April 19, 2016: Journal of Maternal-fetal & Neonatal Medicine
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