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Enrique Gonzalez-Díaz, Camino Fernández Fernández, Maria Jose Fernández Galguera, Alfonso Fernández Corona
INTRODUCTION AND HYPOTHESIS: The aim of this study was to describe perineum deformation during the final part of delivery and suggest a modification of the episiotomy cut to increase accuracy for obtaining a suitable angle (45°) for surgical wound suture. METHODS: This prospective study enrolled 45 primiparous women. The perineum at rest was marked with five lines (0°, 30°, 45°, 60°, 90°), and each line was marked with two dots (point A-B: to 2-3 cm from initial point in fourchette, respectively)...
October 21, 2016: International Urogynecology Journal
George Kokosis, Zhifei Sun, Yash J Avashia, Mohamed A Adam, Howard Levinson, Detlev Erdmann, Christopher R Mantyh, John Migaly
BACKGROUND: The aim of this study was to compare wound complications from V-Y flap vs primary closure in the setting of abdominoperineal resection. METHODS: This was a single institution retrospective review (1999-2014). The main outcome measures were any wound complication, hospital length of stay, and unplanned readmissions. RESULTS: Among 80 patients included, 21 (26%) received reconstruction with V-Y flap. Compared with those who received primary closure, patients who underwent V-Y flap reconstruction had lower rates of overall wound complications (14...
July 21, 2016: American Journal of Surgery
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
Vincenzo Vindigni, Carlotta Scarpa, Erica Dalla Venezia, Franco Bassetto
INTRODUCTION: Fournier's gangrene is a rare disease that affects the genital, abdominal, and perineal regions and leads to death if not treated promptly. CASE REPORT: A 42-year-old, obese woman presented to the authors' department affected by Fournier's gangrene. In order to treat her abdominal and genital regions, the authors performed a surgical debridement followed by combined therapy with antibiotics and topical negative pressure wound therapy (NPWT) with instillation plus saline solution...
October 2016: Wounds: a Compendium of Clinical Research and Practice
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
Joseph Tseng, Peter Poullos
Fournier's gangrene is a severe polymicrobial necrotizing fasciitis of the perineal, genital, or perianal regions. The classic presentation is severe pain and swelling with systemic signs. Crepitus and cutaneous necrosis are often seen. Characteristic CT findings include subcutaneous gas and inflammatory stranding. Unless treated aggressively, patients can rapidly become septic and die. Factitious Disorder is the falsification of one's own of medical or psychological signs and symptoms. Many deceptive methods have been described, from falsely reporting physical or psychological symptoms, to manipulating lab tests, or even injecting or ingesting foreign substances in order to induce illness...
September 2016: Journal of Radiology Case Reports
Kazuhiko Yoshimatsu, Gakuji Osawa, Hajime Yokomizo, Yuki Yano, Sachiyo Okayama, Akiko Sakuma, Masaya Satake, Yasufumi Yamada, Shinichi Asaka, Takebumi Usui, Kentaro Yamaguchi, Shunichi Shiozawa, Takeshi Shimakawa, Takao Katsube, Yoshihiko Naritaka
A 78-year-old man visited our hospital with a prolapsed hemorrhoid. He was referred to the dermatology unit due to the thickness and redness of the perianal skin. He was diagnosed as having extra mammary Paget's disease by skin biopsy. After a biopsy of the anal polyp was performed to investigate the primary site, he was diagnosed with early anal canal cancer with Pagetoid spread and underwent a radical operation. Abdominoperineal resection with skin(D2 prx D3 lymphadenectomy) was performed with perineal reconstruction using a gracilis muscle graft...
October 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Rodolfo Patussi Correia, Laiz Cameirão Bento, Ana Carolina Apelle Bortolucci, Anderson Marega Alexandre, Andressa da Costa Vaz, Daniela Schimidell, Eduardo de Carvalho Pedro, Fabricio Simões Perin, Sonia Tsukasa Nozawa, Cláudio Ernesto Albers Mendes, Rodrigo de Souza Barroso, Nydia Strachman Bacal
Objective: To discuss the implementation of technical advances in laboratory diagnosis and monitoring of paroxysmal nocturnal hemoglobinuria for validation of high-sensitivity flow cytometry protocols. Methods: A retrospective study based on analysis of laboratory data from 745 patient samples submitted to flow cytometry for diagnosis and/or monitoring of paroxysmal nocturnal hemoglobinuria. Results: Implementation of technical advances reduced test costs and improved flow cytometry resolution for paroxysmal nocturnal hemoglobinuria clone detection...
July 2016: Einstein
Georgios-Marios Makris, Nikiforita Poulakaki, Aristea-Maria Papanota, Evgenia Kotsifa, Theodoros N Sergentanis, Theodora Psaltopoulou
BACKGROUND: Hidradenitis suppurativa (HS) is a chronic inflammatory disease that frequently involves the perineal and perianal regions. The association between HS and malignant transformation is a rare but under recognized phenomenon. OBJECTIVE: This systematic review aims to summarize all available cases of vulvar and perianal/perineal cancer emerging in patients with HS, describing clinical and therapeutic particularities of these coexisting conditions in female patients...
October 13, 2016: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
Mahamud-Ur Rashid, Zillur Rahman, Vanessa Burrowes, Jamie Perin, Munshi Mustafiz, Shirajum Monira, K M Saif-Ur-Rahman, Sazzadul Islam Bhuyian, Md Toslim Mahmud, R Bradley Sack, David Sack, Munirul Alam, Christine Marie George
OBJECTIVE: In urban Dhaka, Bangladesh, 30% of source water samples collected from the households of cholera patients had detectable Vibrio cholerae. These findings indicate an urgent need for a public health intervention for this population. The Crystal VC(®) dipstick test is a rapid method for detecting V.cholerae in stool and water. However, to date no study has investigated the use of the rapid dipstick test for household surveillance of stored drinking water. METHODS: The efficacy of the Crystal VC(®) dipstick test for detecting V...
October 18, 2016: Tropical Medicine & International Health: TM & IH
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
Shi Lu, Hong-Ling Zhang, Ya-Jun Zhang, Qing-Chun Shao
This study investigated the prevalence and risk factors of urinary incontinence (UI) among perimenopausal women in Wuhan. A cross-sectional survey was performed on 1067 women aged 40-65 years sampled in Wuhan urban area from April to October 2014. Information about demographic characteristics, menstruation, parity and UI symptoms was collected using a questionnaire. The data were evaluated by Chi-square test and multiple Logistic regression analysis. The prevalence rate of UI was 37.2%, with stress UI (32.2%) being more prevalent than urgency UI (21...
October 2016: Journal of Huazhong University of Science and Technology. Medical Sciences
J Lindert, O Hiort, L Tüshaus, K Tafazzoli-Lari, L Wünsch
A variable spectrum of urogenital malformations exists in girls with congenital adrenal hyperplasia (CAH). The vagina may enter the urethra at a variable level, and relations to the sphincter complex vary accordingly. Furthermore, an enlarged clitoris and variations in the bladder sphincter anatomy can be found. Endoscopy, genitography or magnetic resonance imaging (MRI) are commonly used for the assessment of these anomalies, and to provide information for counselling and treatment. When surgery is planned, introitoplasty cosmetical reduction of the clitoris and labioplasty are discussed with the families; introitoplasty is the most demanding aspect...
September 10, 2016: Journal of Pediatric Urology
Gabriel Ogaya-Pinies, Yash Kadakia, Hariharan Palayapalayam-Ganapathi, Tracey Woodlief, Cathy Jenson, Vipul Patel
BACKGROUND: One of the key factors contributing to morbidity associated with salvage radical prostatectomy is a significant vesicourethral anastomosis (VUA) disruption or postoperative tissue dehiscence in the region of the distal bladder neck that causes a large prolonged urinary leak, perineal pain, and delayed catheter removal. OBJECTIVE: To describe our surgical technique using a urinary bladder extracellular matrix (UB-ECM) scaffold incorporated into the base of the VUA and the distal bladder neck during salvage robot-assisted radical prostatectomy (sRARP) and to assess outcomes and safety...
October 14, 2016: European Urology
Shintaro Makino, Jun Takeda, Satoru Takeda
No abstract text is available yet for this article.
October 2016: Taiwanese Journal of Obstetrics & 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
Owen M Slater, Jeanine Peters-Kennedy, Manigandan Lejeune, David Gummer, Bryan Macbeth, Amy Warren, Tomy Joseph, Hong Li, Cristina W Cunha, Pádraig J Duignan
Malignant catarrhal fever-like clinical disease was diagnosed in a free-ranging bighorn sheep ( Ovis canadensis ) from Alberta, Canada, in June 2015. Antemortem and gross pathology findings included muscle atrophy, marked weight loss, and bilaterally symmetric alopecia with hyperpigmentation and crusting over the face, medial surfaces of the pinnae, dorsal trunk, distal limbs, perineal area, and tail. Histologically, the skin lesions were characterized by granulomatous mural folliculitis with numerous multinucleated giant cells and fewer lymphocytes and eosinophils consistent with previous reports of chronic ovine herpesvirus-2 (OvHV-2) infection...
October 17, 2016: Journal of Wildlife Diseases
Amanda J Ampt, Vijay Roach, Christine L Roberts
OBJECTIVES: To compare the characteristics of women who have undergone vulvoplasty with those of other women of reproductive age; to quantify short term adverse events and complications; to determine any association between vulvoplasty and subsequent outcomes for women giving birth. DESIGN, SETTING AND PARTICIPANTS: A population-based record linkage study, analysing New South Wales Admitted Patient Data Collection and NSW Perinatal Data Collection data. The characteristics of all women who had vulvoplasties in NSW hospitals during 2001-2013 were compared with those of all women of reproductive age...
October 17, 2016: Medical Journal of Australia
Marta Penna, Roel Hompes, Steve Arnold, Greg Wynn, Ralph Austin, Janindra Warusavitarne, Brendan Moran, George B Hanna, Neil J Mortensen, Paris P Tekkis
OBJECTIVE: This study aims to report short-term clinical and oncological outcomes from the international transanal Total Mesorectal Excision (taTME) registry for benign and malignant rectal pathology. BACKGROUND: TaTME is the latest minimally invasive transanal technique pioneered to facilitate difficult pelvic dissections. Outcomes have been published from small cohorts, but larger series can further assess the safety and efficacy of taTME in the wider surgical population...
October 4, 2016: Annals of Surgery
Thirumaraichelvan Perungo, Johnrose John Grifson, Anbazhagan Amudhan, Kannan Devy Gounder
A 23-year-old woman presented to the outpatients department with symptoms of acute onset perianal pain of 2 weeks' duration and constipation. She was a known case of Hirschsprung's disease and was operated on in infancy. Rectal examination ruled out acute fissure or perianal sepsis, and subsequent colonoscopy was normal. Because of persistent symptoms, she was evaluated further by imaging which revealed a presacral lesion closely abutting the nerve roots, suggesting the possibility of a nerve sheath tumour...
October 12, 2016: BMJ Case Reports
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