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Pelvic floor

Abdul H Sultan, Ash Monga, Joseph Lee, Anton Emmanuel, Christine Norton, Giulio Santoro, Tracy Hull, Bary Berghmans, Stuart Brody, Bernard T Haylen
INTRODUCTION: The terminology for anorectal dysfunction in women has long been in need of a specific clinically-based Consensus Report. METHODS: This Report combines the input of members of the Standardization and Terminology Committees of two International Organizations, the International Urogynecological Association (IUGA) and the International Continence Society (ICS), assisted on Committee by experts in their fields to form a Joint IUGA/ICS Working Group on Female Anorectal Terminology...
October 22, 2016: Neurourology and Urodynamics
Gijsbert D Musters, Charlotte E L Klaver, Robbert J I Bosker, Jacobus W A Burger, Peter van Duijvendijk, Boudewijn van Etten, Anna A W van Geloven, Eelco J R de Graaf, Christiaan Hoff, Jeroen W A Leijtens, Harm J T Rutten, Baljit Singh, Ronald J C L M Vuylsteke, Johannes H W de Wilt, Marcel G W Dijkgraaf, Willem A Bemelman, Pieter J Tanis
OBJECTIVE: To determine the effect of biological mesh closure on perineal wound healing after extralevator abdominoperineal resection (eAPR). BACKGROUND: Perineal wound complications frequently occur after eAPR with preoperative radiotherapy for rectal cancer. Cohort studies have suggested that biological mesh closure of the pelvic floor improves perineal wound healing. METHODS: Patients were randomly assigned to primary closure (standard arm) or biological mesh closure (intervention arm)...
September 20, 2016: Annals of Surgery
Casey L Kinman, Courtney A Lemieux, Anubhav Agrawal, Jeremy T Gaskins, Kate V Meriwether, Sean L Francis
INTRODUCTION AND HYPOTHESIS: A variety of factors affect the amount of bother experienced by different women with equivalent pelvic organ prolapse (POP). The goal of this study was to describe the relationship between age and bother experienced from objectively equivalent stages of POP. METHODS: Records of all patients presenting to a pelvic floor subspecialty clinic between January 2014 and March 2015 were reviewed. Women with POP stage ≥ 2 were included...
October 20, 2016: International Urogynecology Journal
R M Islam, R J Bell, B Billah, M B Hossain, S R Davis
OBJECTIVE: To investigate the prevalence of, and risk factors for, pelvic floor disorders (PFDs) in women in Bangladesh. METHODS: A nationally representative sample of 1590 Bangladeshi women, aged 30-59 years, was recruited using a multistage cluster sampling technique, between September 2013 and March 2014. Urinary incontinence (UI), fecal incontinence (FI) and pelvic organ prolapse (POP) were assessed using validated questionnaires. The weighted prevalence and the factors associated with each PFD were investigated using multivariable weighted logistic regression...
October 20, 2016: Climacteric: the Journal of the International Menopause Society
Tsia-Shu Lo, Yi-Hao Lin, Hsiao-Chien Chu, Eileen Feliz M Cortes, Leng Boi Pue, Yiap Loong Tan, Ma Clarissa Uy-Patrimonio
AIM: By investigating the association of urodynamics and urogenital nerve growth factor (NGF) levels in vaginal mesh surgery, we may be able to associate the likelihood of postoperative lower urinary tract symptoms developing as a result of synthetic mesh implanted for pelvic floor reconstructive surgery. METHODS: Thirty-eight female Sprague-Dawley rats were divided into three groups: mesh, sham (no mesh), and control. Urodynamic study and NGF analysis of the urogenital tissues were done and results were compared among all groups...
October 20, 2016: Journal of Obstetrics and Gynaecology Research
Ryan E Stafford, Rafeef Aljuraifani, François Hug, Paul W Hodges
OBJECTIVES: To investigate whether increases in stiffness can be detected in the anatomical region associated with the striated urethral sphincter during voluntary activation using shear wave elastography; to identify the location and area of the stiffness increase relative to the point of greatest dorsal displacement of the mid urethra (i.e. striated urethral sphincter); and to determine the relationship between muscle stiffness and contraction intensity. SUBJECTS AND METHODS: Ten healthy men participated...
October 18, 2016: BJU International
Marian Wiegersma, Chantal M C R Panman, Marjolein Y Berger, Henrica C W De Vet, Boudewijn J Kollen, Janny H Dekker
BACKGROUND: The Pelvic Floor Distress Inventory-20 is used to evaluate symptoms and treatment effects in women with pelvic floor disorders. To interpret changes in the scores of this inventory, information is needed on what patients and clinicians perceive as the minimal important (meaningful) change. Although this change in the inventory score has previously been investigated in women undergoing pelvic floor surgery, the results could not be generalized to women with milder symptoms (i...
October 14, 2016: American Journal of Obstetrics and Gynecology
Renaud de Tayrac, Vincent Letouzey
PURPOSE OF REVIEW: Over the past 20 years, several randomized studies have compared Valsalva and spontaneous pushing techniques during vaginal delivery. This review summarizes current medical knowledge concerning their maternal and fetal consequences, focusing on pelvic and perineal outcomes. RECENT FINDINGS: We selected nine randomized controlled trials comparing Valsalva and spontaneous pushing, and a secondary analysis of a randomized controlled trial comparing different methods of perineal protection...
October 5, 2016: Current Opinion in Obstetrics & Gynecology
Jan Keller, Amelie U Wiedemann, Diana Hilda Hohl, Urte Scholz, Silke Burkert, Mark Schrader, Nina Knoll
OBJECTIVES: Extending individual planning of health behaviour change to the level of the dyad, dyadic planning refers to a target person and a planning partner jointly planning the target person's health behaviour change. To date, predictors of dyadic planning have not been systematically investigated. Integrating cognitive predictors of individual planning with four established predictor domains of social support provision, we propose a framework of predictors of dyadic planning. Including target persons' and partners' perspectives, we examine these predictor domains in the context of prostate cancer patients' rehabilitative pelvic floor exercise (PFE) following radical prostatectomy...
October 15, 2016: British Journal of Health Psychology
Liga Blyholder, Elizabeth Chumanov, Kathleen Carr, Bryan Heiderscheit
BACKGROUND: With a recent increase in running popularity, more women choose to run during and after pregnancy. Little research has examined exercise behaviors and postpartum health conditions of runners. HYPOTHESIS: Antenatal and postpartum exercise is beneficial in reducing certain postpartum health conditions. STUDY DESIGN: Cross-sectional study. LEVEL OF EVIDENCE: Level 5. METHODS: A self-administered, online survey was developed that consisted of questions regarding antenatal and postpartum exercise behaviors, maternal history, and postpartum health conditions...
October 14, 2016: Sports Health
Yuko M Komesu, Holly E Richter, Darrell L Dinwiddie, Nazema Y Siddiqui, Vivian W Sung, Emily S Lukacz, Beri Ridgeway, Lily A Arya, Halina M Zyczynski, Rebecca G Rogers, Marie Gantz
INTRODUCTION AND HYPOTHESIS: We describe the rationale and methods of a study designed to compare vaginal and urinary microbiomes in women with mixed urinary incontinence (MUI) and similarly aged, asymptomatic controls. METHODS: This paper delineates the methodology of a supplementary microbiome study nested in an ongoing randomized controlled trial comparing a standardized perioperative behavioral/pelvic floor exercise intervention plus midurethral sling versus midurethral sling alone for MUI...
October 13, 2016: International Urogynecology Journal
Rebecca Chambers, Adam Lucht, Aisling Reihill, Judith Hough
INTRODUCTION AND HYPOTHESIS: Pelvic floor (PF) dysfunction in patients with cystic fibrosis (CF) is poorly understood due to lack of research. The aim of this study was to examine the prevalence, risk factors and bothersomeness of PF dysfunction and its implications for the clinical management of CF. METHODS: Of 64 adults with CF approached at a tertiary hospital, 60 were surveyed. A clinically meaningful score on the Australian Pelvic Floor Questionnaire (APFQ) is ≥1 in each of the bladder, bowel, sexual function and prolapse sections or a global PF score of ≥3...
October 13, 2016: International Urogynecology Journal
G Cucinella, G Calagna, G Romano, G Di Buono, G Gugliotta, S Saitta, G Adile, M Manzone, G Accardi, A Perino, A Agrusa
The apical prolapse has always been considered the most complex of the defects of the pelvic floor, for both the difficulty of the surgical corrective technique and for the high post-surgical recurrence rate. Today, the laparoscopic sacrocolpopexy can be considered the standard treatment for apical prolapse. In the last years, several author performed robotic sacrocolpopexy, obtaining positive results. So, we developed a casecontrol study in order to compare the surgical outcome of robotic group with a control group of laparoscopic approach in patients with symptomatic apical pro-lapsed between January 2015 and December 2015 at University Hospital Policlinico "P...
May 2016: Il Giornale di Chirurgia
Alison Bardsley
Urinary incontinence is a common problem that is often under-reported due to the embarrassing nature and social stigma attached. Urinary incontinence can have a considerable effect on an individual's quality of life, but can be significantly improved with correct assessment, treatment and management. Conservative treatment options, including pelvic floor exercises, bladder retraining and fluid modification, are recommended before referral to secondary services. This article provides an overview of the main types of urinary incontinence, and summarises recent guidelines for the assessment, diagnosis and effective conservative treatment options for them, and when a referral to specialist care is required...
October 13, 2016: British Journal of Nursing: BJN
Wei Ge, Song-Song Jiang, Wang Qi, Hao Chen, Li-Ming Zheng, Gang Chen
GOAL: To share our experience of extra-levator abdominoperineal excision (ELAPE) for low rectal cancer, focusing on perineal repair with biological mesh. METHODS: We retrospectively analyzed medical records of all patients with low rectal cancer who underwent the ELAPE procedure using biological mesh for perineal repair at the Gastrointestinal Surgery of Nanjing Drum Power Hospital between January 2013 and September 2015. All patients were closely followed up to now...
October 6, 2016: Oncotarget
Alison J Hainsworth, Sophie A Pilkington, Catherine Grierson, Elizabeth Rutherford, Alexis Mp Schizas, Karen P Nugent, Andrew B Williams
OBJECTIVES: Defaecatory MRI allows multicompartmental assessment of defaecatory dysfunction but is often inaccessible. Integrated total pelvic floor ultrasound (transperineal, transvaginal, endoanal) may provide a cheap, portable alternative. Accuracy of total pelvic floor ultrasound for anatomical abnormalities when compared to defaecatory MRI was assessed. METHODS: The dynamic images from 68 women who had undergone integrated total pelvic floor ultrasound and defaecatory MRI between 2009 and 2015 were blindly reviewed...
October 12, 2016: British Journal of Radiology
R Thuret, S Hurel, F Kleinclauss, M O Timsit
OBJECTIVES: To describe lower urinary tract symptoms (LUTS) and their management in renal transplant candidates and recipients. MATERIAL AND METHODS: Relevant publications were identified through Medline ( and Embase ( database using the following keywords, alone or in association: "transplantation", "prostate hyperplasia", "transurethral resection of prostate", "urinary incontinence", "LUTS", "pelvic floor dysfunction"...
October 7, 2016: Progrès en Urologie
Jwan Al-Mukhtar Othman, Sigvard Åkervall, Ian Milsom, Maria Gyhagen
BACKGROUND: A systematic survey of pelvic floor disorders in nulliparous women has not been presented previously. OBJECTIVE: The purpose of this study was to determine the prevalence of urinary incontinence parameters in a large cohort of non-pregnant, nulliparous women, and thereby construct a reference group for comparisons with parous women. STUDY DESIGN: This postal and web-based questionnaire survey was conducted in 2014. The study population was identified from the Total Population Register in Sweden and comprised women who had not given birth and were aged 25-64 years...
October 6, 2016: American Journal of Obstetrics and Gynecology
Diego Raimondo, Aly Youssef, Mohamed Mabrouk, Simona Del Forno, Valentina Martelli, Gianluigi Pilu, Nicola Rizzo, Letizia Zannoni, Roberto Paradisi, Renato Seracchioli
OBJECTIVE: Pelvic floor muscle (PFM) dysfunction seems to play an important role in the pathophysiology of pain in women with with pelvic pain syndromes, including deep infiltrating endometriosis (DIE). The aim of the study was to evaluate static and dynamic morphometry of PFM in women affected by DIE, in comparison to asymptomatic control women, using three-dimensional (3D) and four-dimensional (4D) transperineal ultrasound. METHODS: A pilot, prospective study was conducted between March 2015 and November 2015, at our tertiary center...
October 8, 2016: Ultrasound in Obstetrics & Gynecology
Adil E Bharucha, Tae Hee Lee
Although pelvic pain is a symptom of several structural anorectal and pelvic disorders (eg, anal fissure, endometriosis, and pelvic inflammatory disease), this comprehensive review will focus on the 3 most common nonstructural, or functional, disorders associated with pelvic pain: functional anorectal pain (ie, levator ani syndrome, unspecified anorectal pain, and proctalgia fugax), interstitial cystitis/bladder pain syndrome, and chronic prostatitis/chronic pelvic pain syndrome. The first 2 conditions occur in both sexes, while the latter occurs only in men...
October 2016: Mayo Clinic Proceedings
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