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Defecatory Dysfunction

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https://www.readbyqxmd.com/read/28668155/mr-imaging-of-the-pelvic-floor
#1
REVIEW
Gaurav Khatri, Alberto Diaz de Leon, Mark E Lockhart
Pelvic floor dysfunction is a term used to describe a broad set of conditions including pelvic organ prolapse, urinary or fecal incontinence, defecatory dysfunction, and chronic pelvic pain that frequently affects multiple compartments of the pelvic floor. Imaging is important, because physical examination may not be adequate as the only means of evaluating pelvic floor disorders. This article reviews pertinent pelvic floor anatomy as well as the technique for performing, interpreting, and reporting abnormalities seen on MR defecography examinations in the anterior, middle, and posterior compartments...
August 2017: Magnetic Resonance Imaging Clinics of North America
https://www.readbyqxmd.com/read/28544473/level-of-vascular-tie-and-its-effect-on-functional-outcome-two-years-after-anterior-resection-for-rectal-cancer
#2
Daniel Kverneng Hultberg, Ashkan A Afshar, Jörgen Rutegård, Marilyne Lange, Markku M Haapamäki, Peter Matthiessen, Martin Rutegård
AIM: Previous research indicates that high tie of the inferior mesenteric artery during anterior resection for rectal cancer might be associated with an increased risk of postoperative functional disturbances. The goal of this population-based retrospective cohort study was to further investigate that association. METHOD: Patients who underwent anterior resection for rectal cancer from April 2011-September 2012 were identified through the Swedish Colorectal Cancer Registry...
May 25, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28374259/anorectal-complications-after-robotic-intersphincteric-resection-for-low-rectal-cancer
#3
Li-Jen Kuo, James Chi-Yong Ngu, Yan-Jiun Huang, Yen-Kuang Lin, Chia-Che Chen, Yiu-Shun Tong, Szu-Chia Huang, Chia-Chen Hu, Shu-Hwa Tan
BACKGROUND: Robotic intersphincteric resection (ISR) has been introduced for sphincter-preservation in the treatment of low rectal cancer. However, many patients experience anorectal symptoms and defecatory dysfunction after ISR. This study aims to evaluate the anorectal complications that develop after ISR. METHODS: The medical records of 108 patients who underwent robotic ISR at Taipei Medical University Hospital, Taipei, Taiwan between December 2011 and June 2016 were retrospectively reviewed...
April 3, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28333818/practice-bulletin-no-176-pelvic-organ-prolapse
#4
(no author information available yet)
Pelvic organ prolapse (POP) is a common, benign condition in women. For many women it can cause vaginal bulge and pressure, voiding dysfunction, defecatory dysfunction, and sexual dysfunction, which may adversely affect quality of life. Women in the United States have a 13% lifetime risk of undergoing surgery for POP (). Although POP can occur in younger women, the peak incidence of POP symptoms is in women aged 70-79 years (). Given the aging population in the United States, it is anticipated that by 2050 the number of women experiencing POP will increase by approximately 50% ()...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28333810/practice-bulletin-no-176-summary-pelvic-organ-prolapse
#5
(no author information available yet)
Pelvic organ prolapse (POP) is a common, benign condition in women. For many women it can cause vaginal bulge and pressure, voiding dysfunction, defecatory dysfunction, and sexual dysfunction, which may adversely affect quality of life. Women in the United States have a 13% lifetime risk of undergoing surgery for POP (1). Although POP can occur in younger women, the peak incidence of POP symptoms is in women aged 70-79 years (2). Given the aging population in the United States, it is anticipated that by 2050 the number of women experiencing POP will increase by approximately 50% (3)...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28265708/clinical-impact-of-bowel-symptoms-in-women-with-pelvic-floor-disorders
#6
José Ananias Vasconcelos Neto, Camila Teixeira Moreira Vasconcelos, Sthela Maria Murad Regadas, Leonardo Robson Pinheiro Sobreira Bezerra, Kathiane Augusto Lustosa, Sara Arcanjo Lino Karbage
INTRODUCTION AND HYPOTHESIS: The aim of this study was to evaluate the correlations between the POP-Q Bp point and the perineal body (Pb) and genital hiatus (Gh) measurements and constipation, anal incontinence, severity of symptoms and quality of life. METHODS: The patients were distributed into two groups according to the posterior vaginal wall Bp point: one group with Bp ≤-1 (without posterior vaginal wall prolapse, control group) and the other group with Bp ≥0 (with posterior vaginal wall prolapse, case group)...
March 6, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28237854/a-randomized-trial-of-relamorelin-for-constipation-in-parkinson-s-disease-move-pd-trial-results-and-lessons-learned
#7
Ronald F Pfeiffer
BACKGROUND: Bowel dysfunction, including both slow transit constipation and defecatory dysfunction, is a frequent and often troubling nonmotor manifestation of Parkinson's disease (PD). A variety of agents are employed for the treatment of constipation in PD, but dissatisfaction with available treatment approaches is common. Relamorelin is a synthetic ghrelin agonist that has demonstrated prokinetic properties within the gastrointestinal tract. METHODS: We carried out a multi-center, randomized, double-blind, placebo-controlled study of relamorelin in patients with PD experiencing chronic, inadequately controlled constipation...
February 14, 2017: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/28106652/prospective-outcomes-of-a-pelvic-floor-rehabilitation-program-including-vaginal-electrogalvanic-stimulation-for-urinary-defecatory-and-pelvic-pain-symptoms
#8
Jennifer J Schmitt, Ruchira Singh, Amy L Weaver, Kristin C Mara, Randina R Harvey-Springer, Felecia R Fick, John A Occhino
OBJECTIVES: This study evaluated our experience after implementing a pelvic floor rehabilitation program including behavioral modification, biofeedback, and vaginal electrogalvanic stimulation (EGS). METHODS: This prospective cohort study evaluated outcomes of patients with pelvic floor dysfunction (urinary or defecatory dysfunction, pelvic pain/dyspareunia) who underwent pelvic floor rehabilitation. Patients received 4 to 7 sessions (1 every 2 weeks) including biofeedback and concluded with 30 minutes of vaginal EGS...
March 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/27926562/long-term-experience-of-magnetic-anal-sphincter-augmentation-in-patients-with-fecal-incontinence
#9
Jeremy Sugrue, Paul-Antoine Lehur, Robert D Madoff, Shane McNevin, Steen Buntzen, Søren Laurberg, Anders Mellgren
BACKGROUND: Magnetic anal sphincter augmentation is a novel technique for the treatment of patients with fecal incontinence. OBJECTIVE: The current study reports the long-term effectiveness and safety of this new treatment modality. DESIGN: This was a prospective multicenter pilot study. SETTINGS: The study was performed at 4 clinical sites in Europe and the United States. PATIENTS: The cohort included patients with severe fecal incontinence for ≥6 months who had previously failed conservative therapy and were implanted with a magnetic anal sphincter device between 2008 and 2011...
January 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/27833469/a-novel-approach-to-mesh-revision-after-sacrocolpopexy
#10
Melissa L Dawson, Rinko Rebecca, Nima M Shah, Kristene E Whitmore
Pelvic organ prolapse (POP) is the herniation of pelvic organs to or beyond the vaginal walls. POP affects 50% of parous women; of those women, 11% will need surgery based on bothersome symptoms. Transvaginal mesh has been used for vaginal augmentation since the 1990s. Complications from mesh use are now more prominent, and include chronic pelvic pain, dyspareunia, vaginal mesh erosion, and urinary and defecatory dysfunction. Presently, there is no consensus regarding treatment of these complications. Reported herein are two cases of women with defecatory dysfunction and pain after sacrocolpopexy who underwent mesh revision procedures performed with both urogynecologic and colorectal surgery...
2016: Reviews in Urology
https://www.readbyqxmd.com/read/27647462/the-importance-of-a-high-rectal-pressure-on-strain-in-constipated-patients-implications-for-biofeedback-therapy
#11
Y Mazor, R Hansen, G Prott, J Kellow, A Malcolm
BACKGROUND: A subset of patients with chronic constipation display a relatively high manometric rectal pressure on strain. We hypothesized that these patients represent a unique phenotype of functional defecatory disorder (FDD) and would benefit from undergoing anorectal biofeedback (BF). METHODS: Of 138 consecutive patients with chronic constipation and symptoms of FDD, 19 were defined as having a high rectal pressure on strain, using a statistically derived cut-off of 78 mm Hg...
March 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/27644075/neuroprotective-and-immunomodulatory-effects-of-raloxifene-in-the-myenteric-plexus-of-a-mouse-model-of-parkinson-s-disease
#12
Andrée-Anne Poirier, Mélissa Côté, Mélanie Bourque, Marc Morissette, Thérèse Di Paolo, Denis Soulet
Motor symptoms in Parkinson's disease (PD) are often preceded by nonmotor symptoms related to dysfunctions of the autonomic nervous system such as constipation, defecatory problems, and delayed gastric emptying. These gastrointestinal impairments are associated with the alteration of dopaminergic (DAergic) neurons in the myenteric plexus of the gut. Recently, we demonstrated the anti-inflammatory properties of estrogens to treat intestinal neurodegeneration in the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) mouse model of PD...
December 2016: Neurobiology of Aging
https://www.readbyqxmd.com/read/27547494/current-trends-in-management-of-defecatory-dysfunction-posterior-compartment-prolapse-and-fecal-incontinence
#13
Heidi Brown, Cara Grimes
While it would be our hope to report that there have been significant gains in the understanding of the correlation between the posterior vaginal compartment and defecatory dysfunction in the last year, this is not the case. Instead, we review the highlights of management of posterior vaginal compartment and defecatory dysfunction including 1) defining and understanding the patient's symptoms; 2) considering systemic disorders, motility dysfunction, and mechanical causes that may be contributing; 3) encouraging conservative management as first-line therapy; and 4) recognizing which surgical options are likely to improve specific symptoms...
June 2016: Current Obstetrics and Gynecology Reports
https://www.readbyqxmd.com/read/27433087/gut-dysfunction-in-parkinson-s-disease
#14
REVIEW
Adreesh Mukherjee, Atanu Biswas, Shyamal Kumar Das
Early involvement of gut is observed in Parkinson's disease (PD) and symptoms such as constipation may precede motor symptoms. α-Synuclein pathology is extensively evident in the gut and appears to follow a rostrocaudal gradient. The gut may act as the starting point of PD pathology with spread toward the central nervous system. This spread of the synuclein pathology raises the possibility of prion-like propagation in PD pathogenesis. Recently, the role of gut microbiota in PD pathogenesis has received attention and some phenotypic correlation has also been shown...
July 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27295950/alteration-of-colonic-excitatory-tachykininergic-motility-and-enteric-inflammation-following-dopaminergic-nigrostriatal-neurodegeneration
#15
Carolina Pellegrini, Matteo Fornai, Rocchina Colucci, Erika Tirotta, Fabio Blandini, Giovanna Levandis, Silvia Cerri, Cristina Segnani, Chiara Ippolito, Nunzia Bernardini, Karolina Cseri, Corrado Blandizzi, György Haskó, Luca Antonioli
BACKGROUND: Parkinson's disease (PD) is frequently associated with gastrointestinal (GI) symptoms, including constipation and defecatory dysfunctions. The mechanisms underlying such disorders are still largely unknown, although the occurrence of a bowel inflammatory condition has been hypothesized. This study examined the impact of central dopaminergic degeneration, induced by intranigral injection of 6-hydroxydopamine (6-OHDA), on distal colonic excitatory tachykininergic motility in rats...
2016: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/27154577/diagnostic-disagreement-between-tests-of-evacuatory-function-a-prospective-study-of-100-constipated-patients
#16
S Palit, N Thin, C H Knowles, P J Lunniss, A E Bharucha, S M Scott
BACKGROUND: Evacuatory dysfunction (ED) is a common cause of constipation and may be sub-classified on the basis of specialist tests. Such tests may guide treatment e.g., biofeedback therapy for 'functional' defecatory disorders (FDD). However, there is no gold standard, and prior studies have not prospectively and systematically compared all tests that are used to diagnose forms of ED. METHODS: One hundred consecutive patients fulfilling Rome III criteria for functional constipation underwent four tests: expulsion of a rectal balloon distended to 50 mL (BE50 ) or until patients experienced the desire to defecate (BEDDV ), evacuation proctography (EP) and anorectal manometry...
October 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/26894803/obesity-and-pelvic-floor-dysfunction-battling-the-bulge
#17
REVIEW
Shireen de Sam Lazaro, Rahel Nardos, Aaron B Caughey
IMPORTANCE: Pelvic floor disorders (PFDs) comprise a broad spectrum of clinical conditions, including urinary incontinence, pelvic organ prolapse, fecal incontinence, and defecatory dysfunction. These disorders are common conditions that generate significant medical, emotional, social, and economic issues for many women. Obese women are disproportionately affected compared with their normal-weight peers, with more than half of women with a body mass index of greater than 35 kg/m(2) reporting a PFD, compared with only 32% in women with a normal body mass index...
February 2016: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/26859123/solitary-pouch-ulcer-a-new-clinical-entity
#18
Victor E Pricolo
Solitary rectal ulcer syndrome is a well-known clinical entity, likely secondary to a defecatory dysfunction. In patients who have undergone restorative proctocolectomy with ileoanal reservoir, it is conceivable that a similar pathophysiology may lead to "solitary pouch ulcer," but such a syndrome has not been reported to date. This article reports 2 such cases and clinical success with lasting symptomatic relief through local therapy and behavior modification rather than anti-inflammatory.
July 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/26630260/advancing-treatment-options-for-chronic-idiopathic-constipation
#19
REVIEW
Eamonn M M Quigley, Leila Neshatian
INTRODUCTION: Chronic constipation is a global problem affecting all ages and associated with considerable morbidity and significant financial burden for society. Though formerly defined on the basis of a single symptom, infrequent defecation; constipation is now viewed as a syndrome encompassing several complaints such as difficulty with defecation, a sense of incomplete evacuation, hard stools, abdominal discomfort and bloating. AREAS COVERED: The expanded concept of constipation has inevitably led to a significant change in outcomes in clinical trials, as well as in patient expectations from new therapeutic interventions...
2016: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/26603727/pelvic-floor-dysfunction-in-inflammatory-bowel-disease
#20
REVIEW
A Bondurri, A Maffioli, P Danelli
Advances in tailored medical therapy and introduction of biologic agents for inflammatory bowel disease (IBD) treatment have ensured long-term disease remission. Some patients, however, still report defecatory symptoms. Patients present with a wide spectrum of conditions - anal incontinence, obstructed defecation and pelvic pain among the most frequent - that have a great impact on their quality of life. Due to IBD diagnosis, little relevance is attributed to this type of symptoms and their epidemiologic distribution is unknown...
December 2015: Minerva Gastroenterologica e Dietologica
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