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https://www.readbyqxmd.com/read/28203348/flibanserin-for-hypoactive-sexual-desire-disorder-place-in-therapy
#1
REVIEW
Faina Gelman, Jessica Atrio
The pathophysiology, diagnosis and treatment of female sexual interest in pre- and post-menopausal women present a complex arena for patients and physicians to navigate. Flibanserin was the first pharmacologic treatment, approved by the United States Food and Drug Administration in August 2015, for hypoactive sexual desire disorder (HSDD) in premenopausal women. Side effects, contraindications and lack of approval in postmenopausal women are all limitations, as are issues surrounding patient and physician knowledge and access...
January 2017: Therapeutic Advances in Chronic Disease
https://www.readbyqxmd.com/read/28197646/an-observational-follow-up-study-on-pelvic-floor-disorders-to-3-5-years-after-delivery
#2
Karen Ng, Rachel Yau Kar Cheung, Lai Loi Lee, Tony Kwok Hung Chung, Symphorosa Shing Chee Chan
INTRODUCTION AND HYPOTHESIS: This study aimed to determine the prevalence of urinary incontinence (UI), fecal incontinence (FI), and pelvic organ prolapse (POP) 3-5 years after the first pregnancy and their associated risk factors. METHODS: We assessed 506 women using the Pelvic Floor Distress Inventory (PFDI) and the Pelvic Floor Impact Questionnaire (PFIQ). Maternal characteristics and obstetric data were analyzed using descriptive analysis, independent sample t test, chi-squared test, and logistic regression...
February 14, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28185025/constipation-pathophysiology-and-current-therapeutic-approaches
#3
Amol Sharma, Satish Rao
Chronic constipation is a common, persistent condition affecting many patients worldwide, presenting significant economic burden and resulting in substantial healthcare utilization. In addition to infrequent bowel movements, the definition of constipation includes excessive straining, a sense of incomplete evacuation, failed or lengthy attempts to defecate, use of digital manoeuvres for evacuation of stool, abdominal bloating, and hard consistency of stools. After excluding secondary causes of constipation, chronic idiopathic or primary constipation can be classified as functional defecation disorder, slow-transit constipation (STC), and constipation-predominant irritable bowel syndrome (IBS-C)...
February 10, 2017: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/28177993/effects-of-hysterectomy-on-pelvic-floor-disorders-a-longitudinal-study
#4
Akin Firat Kocaay, Derya Oztuna, Filiz Akin Su, Atilla Halil Elhan, Mehmet Ayhan Kuzu
BACKGROUND: Hysterectomy might adversely affect pelvic floor functions and result in many different symptoms, such as urinary and anal incontinence, obstructed defecation, and constipation. OBJECTIVE: The aim of this prospective study was to evaluate the influence of hysterectomy on pelvic floor disorders. DESIGN: This was a prospective and longitudinal study. SETTINGS: The study was conducted at the Ankara University Department of Surgery and the Dr Zekai Tahir Burak Women's Health Research and Education Hospital between September 2008 and March 2011...
March 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28170477/onabotulinumtoxina-vs-sacral-neuromodulation-for-urgency-incontinence-reply
#5
LETTER
Cindy L Amundsen, Holly E Richter, Dennis Wallace
No abstract text is available yet for this article.
7, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28144214/functional-disorders-rectocele
#6
REVIEW
W Conan Mustain
Rectoceles are a very common finding in patients, and symptoms most commonly include pelvic pain, pressure, or difficulty with passing stool. However, there are often other associated pelvic floor disorders that accompany rectoceles, making the clinical significance of it in an individual patient often hard to determine. When evaluating a patient with a rectocele, a thorough history and physical exam must be conducted to help delineate other causes of these symptoms. Treatment consists of addressing other defecatory disorders through various methods, with surgery reserved for select cases in which obstructed defecation is well documented...
February 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28144213/abdominal-approaches-to-rectal-prolapse
#7
REVIEW
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
https://www.readbyqxmd.com/read/28144212/methods-of-evaluation-of-anorectal-causes-of-obstructed-defecation
#8
REVIEW
Anne C Fabrizio, Yewande Alimi, Anjali S Kumar
Obstructed defecation is a complex disorder that results in impaired propagation of stool from the rectum. It is one of the major subtypes of functional constipation and can be secondary to either functional or anatomic etiologies. Patients with obstructed defecation typically present with symptoms of abdominal discomfort, a sensation of incomplete evacuation and rectal obstruction, passage of hard stools, the need for rectal or vaginal digitation, excessive straining, and reduced stool frequency. Evaluation of obstructed defecation is multimodal, starting with a thorough history and physical examination with focus on the abdominal, perineal, and rectal examination...
February 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28144209/functional-disorders-of-constipation-paradoxical-puborectalis-contraction-and-increased-perineal-descent
#9
REVIEW
Isaac Payne, Leander M Grimm
Paradoxical puborectalis contraction (PPC) and increased perineal descent (IPD) are subclasses of obstructive defecation. Often these conditions coexist, which can make the evaluation, workup, and treatment difficult. After a thorough history and examination, workup begins with utilization of proven diagnostic modalities such as cinedefecography and anal manometry. Advancements in technology have increased the surgeon's diagnostic armamentarium. Biofeedback and pelvic floor therapy have proven efficacy for both conditions as first-line treatment...
February 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28134700/direct-and-indirect-effects-of-personality-traits-on-psychological-distress-in-women-with-pelvic-floor-disorders
#10
Tal Yaakobi, Jonathan E Handelzalts, Yoav Peled, Sigal Levy, Arnon Wiznitzer, Haim Krissi
OBJECTIVES: The diagnosis and treatment of pelvic floor disorders may involve subjective self-report symptom measures that may be related to personality traits. We aimed to construct a model that integrates pelvic floor disorders, personality variables (optimism and neuroticism), psychological distress, and related demographic variables. METHODS: In a cross-sectional study, conducted between August 2014 and June 2015, 155 women following an intake to an urogynecology outpatient clinic of a tertiary health center completed personality questionnaires of optimism and neuroticism (Life Orientation Test-Revised, 10-item Big Five Inventory), pelvic floor symptoms (Pelvic Floor Distress Inventory Short Form), psychological distress (18-item Brief Symptom Inventory), and a demographic questionnaire...
January 27, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28133711/treatment-of-pelvic-floor-disorders-following-neobladder
#11
REVIEW
Nathan Littlejohn, Joshua A Cohn, Casey G Kowalik, Melissa R Kaufman, Roger R Dmochowski, W Stuart Reynolds
Radical cystectomy remains the gold standard treatment for organ-confined high-grade recurrent or muscle-invasive bladder cancer. Orthotopic neobladder urinary diversion following cystectomy represents an option for patients wishing for continent urinary diversion. Female patients who undergo radical cystectomy with orthotopic bladder substitution are at risk for developing both common and neobladder-specific disorders of the pelvic floor, including urinary incontinence, hypercontinence, vaginal prolapse, and neobladder-vaginal fistula...
January 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28118172/knowledge-perceptions-and-attitudes-toward-pelvic-organ-prolapse-and-urinary-incontinence-in-spanish-speaking-latinas
#12
Elisha Jackson, Loretta Hernandez, Veronica T Mallett, T Ignacio Montoya
OBJECTIVES: The aim of the study was to explore individual views and perceptions of Spanish-speaking Latinas living on the US/Mexico border toward pelvic organ prolapse (POP) and urinary incontinence (UI), including awareness of conditions, implications of diagnoses, knowledge, and attitudes toward available treatment options. METHODS: Spanish-speaking Latina women were recruited from clinics at Texas Tech University Health Sciences Center El Paso. Focus group discussions were conducted, addressing topics including female pelvic anatomy, perceived etiology and course of POP and UI, and attitudes toward treatment options...
January 24, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28118170/histologic-anatomy-of-the-anterior-vagina-and-urethra
#13
Donna Mazloomdoost, Lauren B Westermann, George Mutema, Catrina C Crisp, Steven D Kleeman, Rachel N Pauls
BACKGROUND: Vaginal and urethral histology is important to understanding the pathophysiology of the pelvic floor. METHODS: En bloc removal of 4 female cadaveric pelvises was performed, with 18 to 25 serial sections obtained from each. The vaginal and urethral lengths were divided into distal and proximal sections; urethra was divided into anterior and posterior segments as well. Innervation and vasculature were qualified as small and large and quantified per high-power field...
January 24, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28116695/update-on-the-management-of-chronic-constipation
#14
REVIEW
Jenna Koliani-Pace, Brian E Lacy
Chronic constipation (CC) is a highly prevalent disorder encountered by health care providers of all specialties. The diagnosis can be confidently made by taking a careful history, evaluating for warning signs and symptoms, performing an examination, including a digital rectal exam, and using the Rome IV criteria. Treatment should begin at the first visit; most patients require few diagnostic tests to make, or confirm, the diagnosis of CC. Assuming that the patient has persistent symptoms of constipation, despite using traditional therapy (fiber, osmotic agents), then patients should be offered one of the newer treatments, rather than repeating prior treatments, which is a common practice...
January 23, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28089729/urinary-biomarkers-in-women-with-refractory-urgency-urinary-incontinence-randomized-to-sacral-neuromodulation-versus-onabotulinumtoxina-compared-to-controls
#15
Holly E Richter, Pamela Moalli, Cindy L Amundsen, Anna P Malykhina, Dennis Wallace, Rebecca Rogers, Deborah Myers, Maria Paraiso, Michael Albo, Haolin Shi, Tracy Nolen, Susie Meikle, R Ann Word
PURPOSE: To measure urinary biomarker levels in women with refractory urgency urinary incontinence (UUI) and controls at baseline and 6 months post treatment from sacral neuromodulation (SNM) or intradetrusor injection onabotulinumtoxinA and to assess association of baseline biomarkers to post treatment UUI episodes (UUIE) and overactive bladder (OAB) symptom bother outcomes. MATERIALS AND METHODS: First morning urines were collected from consented trial participants and age-matched women without UUI...
January 13, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28073797/physical-and-cultural-determinants-of-postpartum-pelvic-floor-support-and-symptoms-following-vaginal-delivery-a-protocol-for-a-mixed-methods-prospective-cohort-study
#16
Ingrid E Nygaard, Erin Clark, Lauren Clark, Marlene J Egger, Robert Hitchcock, Yvonne Hsu, Peggy Norton, Ana Sanchez-Birkhead, Janet Shaw, Xiaoming Sheng, Michael Varner
INTRODUCTION: Pelvic floor disorders (PFDs), including pelvic organ prolapse (POP), stress and urgency urinary incontinence, and faecal incontinence, are common and arise from loss of pelvic support. Although severe disease often does not occur until women become older, pregnancy and childbirth are major risk factors for PFDs, especially POP. We understand little about modifiable factors that impact pelvic floor function recovery after vaginal birth. This National Institutes of Health (NIH)-funded Program Project, 'Bridging physical and cultural determinants of postpartum pelvic floor support and symptoms following vaginal delivery', uses mixed-methods research to study the influences of intra-abdominal pressure, physical activity, body habitus and muscle fitness on pelvic floor support and symptoms as well as the cultural context in which women experience those changes...
January 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28027607/third-or-fourth-degree-intrapartum-anal-sphincter-tears-are-associated-with-levator-ani-avulsion-in-primiparas
#17
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/28000194/-efficacy-analysis-of-acupuncture-with-biofeedback-in-the-treatment-of-patients-with-functional-anorectal-pain
#18
Ling Zheng, Shuqing Ding, Yijiang Ding, Yahong Xue, Huifen Zhou, Min Li, Jianbao Cao, Jing Wang
OBJECTIVE: To observe the short- and long-term efficacy of acupuncture combined with biofeedback in the treatment of functional anorectal pain (FARP). METHODS: Clinical data of 142 patients who met the functional gastrointestinal disorders and functional anorectal pain based on criteria of Rome III( undergoing acupuncture with biofeedback therapy from August 2010 to November 2015 in Pelvic Floor Center of The Third Affiliated Hospital of Nanjing University of Chinese Medicine were retrospectively analyzed...
December 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28000187/-evaluation-of-test-methods-for-defecation-disorders
#19
Zhihui Huang, Ning Dai
Defecation disorders is a common gastrointestinal disease characterized by slow colonic transit and/or paradoxical anal contraction. Gastrointestinal motility test plays an important role in the diagnosis, classification and treatment of defecation disorders. Anorectal manometry (ARM) provides comprehensive information about rectal and anal sphincter function, including resting anal sphincter pressure, squeeze anal sphincter pressure, the rectal and anal sphincter pressure changes during an attempted defecation, rectal sensory testing, rectoanal inhibitory reflex and rectal compliance...
December 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28000186/-value-of-anorectal-manometry-in-defecation-disorders-and-its-clinical-interpretation
#20
Shuqing Ding
Bowel dysfunction affected by functional factors, mechanical factors or surgical damage may lead to constipation, fecal incontinence and other overlapped symptoms, which is only the tip of the iceberg. Anorectal manometry can provide combined dysfunction information of four subtypes, including sphincter dysfunction, dyssynergic defecation, sensory disability and insufficient rectal expel force, which are underlying pathophysiology of defecation dysfunction. Anorectal manometry can be helpful in optimizing protocol or predicting success in pelvic floor dyssynergic syndrome of defecation, fecal incontinence or anorectal pain, stoma closure and pediatric intractable constipation...
December 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
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