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Perineal trauma

Ki Wook Sung, Won Jai Lee, In Sik Yun, Dong Won Lee
BACKGROUND: Perineal defects are commonly encountered during the treatment of conditions such as malignancy, infectious disease, and trauma. Covering large defects in the perineal area is challenging due to its complicated anatomy and the need for functional preservation. METHODS: Fourteen patients who underwent reconstructive surgery with multiple perforator flaps for defects >100 cm(2) in the perineal area were included in this retrospective cohort study. Characteristics of the perforator flap operation and postoperative outcomes were reviewed...
September 2016: Archives of Plastic Surgery
Ömer Barış Yücel, Emre Salabaş, Bahadır Ermeç, Ateş Kadıoğlu
INTRODUCTION: Priapism, taking its name from God Priapus, is total or partial erection lasting longer than 4 hours independent of sexual stimulus and can result in erectile dysfunction. There are three subtypes of priapism. AIM: To review the three subtypes of priapism, their pathophysiology, current treatment options, and complications. METHODS: The literature including priapism guidelines, review articles, and current trial studies was reviewed and the priapism type of God Priapus was investigated according to the mythology...
September 26, 2016: Sexual Medicine Reviews
T Ramhendar, D Keane
BACKGROUND: The transobturator tape (TOT) has been utilized in the surgical management of SUI since 2001 when it was first described and is associated with minimal risk of trauma as its purely perineal insertion avoids entry to the retropubic space. Given its high success rate, low associated peri-operative morbidity and relative ease of insertion, it has been increasingly used as a day case procedure worldwide. AIM: This study aims to demonstrate the suitability of the transobturator tape (TOT) as a day surgery procedure in the Republic of Ireland...
September 28, 2016: Irish Journal of Medical Science
Ziba Mosayebi, Ali Omidian, Amir Hossein Movahedian, Farzad Kompani, Seyyed Saeed Hosseininodeh
INTRODUCTION: Fournier's gangrene is an infective necrotizing fasciitis of external genital and perineal region. Hematologic malignancies and immunocompromised status are predisposing factors. Simultaneous occurrence of Fournier's gangrene and congenital leukemia in neonates is extremely rare. CASE PRESENTATION: We present a case of Fournier's gangrene in a 4-day-old female infant with a necrotic lesion in perineum and no history of trauma or other predisposing condition...
June 2016: Iranian Journal of Pediatrics
Aisha Salim Said, Karim Premji Manji
BACKGROUND: Fetal macrosomia is defined as birth weight ≥4000 g. Several risk factors have been shown to be associated with fetal macrosomia. There has been an increased incidence of macrosomic babies delivered and the antecedent complications. This study assessed the risk factors, maternal and neonatal complications of fetal macrosomia in comparison with normal birth weight neonates. METHODS: A case-control study was conducted at the Muhimbili National Hospital (MNH) maternity and neonatal wards...
2016: BMC Pregnancy and Childbirth
Sophie van Limbeek, Deborah Davis, Marian Currie, Nola Wong
The objective of this review is to determine the effectiveness of non-surgical intrapartum practices in reducing the incidence of severe perineal trauma (third and fourth degree tears) during childbirth.
April 2016: JBI Database of Systematic Reviews and Implementation Reports
Mesut Sipahi, Ergin Arslan, Hasan Börekçi, Faruk Önder Aytekin, Bahadır Külah, Oktay Banlı
Perineal procedures have higher recurrence and lower mortality rates than abdominal alternatives for the treatment of rectal prolapse. Presence of incarceration and strangulation also influences treatment choice. Perineal rectosigmoidectomy is one of the treatment options in patients with incarceration and strangulation, with low mortality and acceptable recurrence rates. This operation can be performed especially to avoid general anesthesia in old patients with co-morbidities. We aimed to present perineal rectosigmoidectomy and diverting loop colostomy in a patient with neurological disability due to spinal trauma and incarcerated rectal prolapse...
2016: Ulusal Cerrahi Dergisi
Dana R Gossett, Douglas Gilchrist-Scott, Diane B Wayne, Susan E Gerber
OBJECTIVE: To evaluate the association of a forceps simulation training curriculum for obstetrics residents on rates of severe perineal lacerations after forceps deliveries. METHODS: This was a retrospective cohort study. We created a novel simulation curriculum for forceps-assisted vaginal delivery based on the best practices of local experts, and trained all residents beginning in 2013. We then retrospectively reviewed all forceps deliveries performed in the 2...
September 2016: Obstetrics and Gynecology
Alix Leader-Cramer, Kimberly Kenton, Bhumy Davé, Dana R Gossett, Margaret Mueller, Christina Lewicky-Gaupp
INTRODUCTION: The impact of obstetric perineal trauma on timing of return to intercourse is unclear, although sexual desire is clearly decreased in these women. In addition, studies examining timing of return to intercourse are cross-sectional and therefore cannot delineate potential reasons that patients might delay return to intercourse. AIM: To identify factors associated with delayed return to intercourse after obstetric anal sphincter injuries. METHODS: This was a planned secondary analysis of a prospective cohort study of women sustaining obstetric anal sphincter injuries during delivery of a full-term singleton infant...
October 2016: Journal of Sexual Medicine
Ching-Hsing Hsieh
Women who undergo vaginal birth apply uterine fundal pressure during the second stage of labor. Uterine fundal pressure is done manually with the practitioner's forearms, elbows, or palms pressed on the uterine fundus at a 30° to 45° angle to the maternal spine in the direction of the pelvis. The pressure is applied in the longitudinal direction. Gentle, firm, and steady pressure is recommended. The various side effects of applying uterine fundal pressure include: uterine rupture, postpartum urinary retention, severe perineal trauma and pain, rib fracture, postpartum dyspareunia, and potential neonatal distress or trauma...
August 2016: Hu Li za Zhi the Journal of Nursing
Gabriel Djedovic, Barbara Del Frari, Johannes Matiasek, David Schiltz, Timm O Engelhardt, Gerhard Pierer, Ulrich M Rieger
Soft tissue defects in the genito-perineal region are predominantly because of trauma, infections, neoplasms or iatrogenic causes. As a result of the region's urological, reproductive and gastrointestinal function, defects in this area may cause devastating physical and psychological consequences as well as diminished sexual functioning. The purpose of this study was to examine the efficacy of implementing a medial thigh lift for defect coverage in the perineal region. A retrospective analysis of all medial thigh lift procedures for defect coverage in the genito-perineal region between November 2010 and March 2015 was conducted at three institutions...
August 1, 2016: International Wound Journal
Malin Edqvist, Ellen Blix, Hanne K Hegaard, Olöf Ásta Ólafsdottir, Ingegerd Hildingsson, Karen Ingversen, Margareta Mollberg, Helena Lindgren
BACKGROUND: Whether certain birth positions are associated with perineal injuries and severe perineal trauma (SPT) is still unclear. The objective of this study was to describe the prevalence of perineal injuries of different severity in a low-risk population of women who planned to give birth at home and to compare the prevalence of perineal injuries, SPT and episiotomy in different birth positions in four Nordic countries. METHODS: A population-based prospective cohort study of planned home births in four Nordic countries...
July 29, 2016: BMC Pregnancy and Childbirth
Scott A Katzman, Betsy Vaughan, Jorge E Nieto, Larry D Galuppo
OBJECTIVE To evaluate the use of a laparoscopic specimen retrieval pouch for removal of intact or fragmented cystic calculi from standing horses. DESIGN Retrospective case series. ANIMALS 8 horses (5 geldings and 3 mares) with cystic calculi. PROCEDURES Physical examination and cystoscopic, ultrasonographic, and hematologic evaluations of urinary tract function were performed for each horse. A diagnosis of cystic calculus was made on the basis of results of cystoscopy and ultrasonography. Concurrent urolithiasis or other urinary tract abnormalities identified during preoperative evaluation were recorded...
August 1, 2016: Journal of the American Veterinary Medical Association
Pravin D Bhingare, Umesh Ravikant Shelke, Yogesh A Bang
It is very uncommon for a boar to become aggressive in nature against human unless they are cornered. A wild boar attacked a 24-year-old male from behind in perineal region. At presentation, he had continuous dribbling of urine and fecal matter from perineal wound. On CT-scan, a well defined tract delineated by contrast was seen between postero-lateral aspect of bladder and anterior wall of rectum, and there was contrast extravasation through perineal wound. After resuscitation, fistula was repaired through abdominal approach, and perineal wound was debrided...
May 2016: Journal of Clinical and Diagnostic Research: JCDR
Olivier Chevallier, Sophie Gehin, Alain Foahom-Kamwa, Pierre Pottecher, Sylvain Favelier, Romaric Loffroy
We report a case of high-flow priapism treated successfully with superselective embolization of the cavernous artery. A 16-year-old male developed post-traumatic priapism subsequent to a fall causing blunt perineal trauma. He presented to our hospital four days after trauma. Immediately after the injury, he suffered painless sustained incomplete erection. High-flow priapism was diagnosed on the basis of color doppler ultrasonography findings. Computed tomography scan showed a high-flow arterio-venous fistula with feeders from branches of the right internal iliac artery...
June 2016: Quantitative Imaging in Medicine and Surgery
Marina B Alvarenga, Sonia Maria Junqueira Vasconcellos de Oliveira, Adriana A Francisco, Flora Maria B da Silva, Marcelo Sousa, Moacyr Roberto Nobre
BACKGROUND AND OBJECTIVE: Episiotomy is associated with perineal pain and healing complications. The low-level laser therapy (LLLT) reduces pain and inflammation and stimulates the healing process. This study aimed to assess the effect of LLLT on pain and perineal healing after an episiotomy. DESIGN/MATERIALS AND METHODS: A randomized, triple-blind, parallel clinical trial with 54 postpartum women who had a spontaneous birth with a right mediolateral episiotomy...
July 18, 2016: Lasers in Surgery and Medicine
Francesca Wuytack, Valerie Smith, Brian J Cleary
BACKGROUND: Many women experience perineal pain after childbirth, especially after having sustained perineal trauma. Perineal pain-management strategies are thus an important part of postnatal care. Non-steroidal anti-inflammatory drugs (NSAIDs) are a commonly used type of medication in the management of postpartum pain and their effectiveness and safety should be assessed. OBJECTIVES: To determine the effectiveness of a single dose of an oral NSAID for relief of acute perineal pain in the early postpartum period...
2016: Cochrane Database of Systematic Reviews
Kate M Levett, C A Smith, A Bensoussan, H G Dahlen
OBJECTIVE: To evaluate the effect of an antenatal integrative medicine education programme in addition to usual care for nulliparous women on intrapartum epidural use. DESIGN: Open-label, assessor blind, randomised controlled trial. SETTING: 2 public hospitals in Sydney, Australia. POPULATION: 176 nulliparous women with low-risk pregnancies, attending hospital-based antenatal clinics. METHODS AND INTERVENTION: The Complementary Therapies for Labour and Birth protocol, based on the She Births and acupressure for labour and birth courses, incorporated 6 evidence-based complementary medicine techniques: acupressure, visualisation and relaxation, breathing, massage, yoga techniques, and facilitated partner support...
2016: BMJ Open
Shalini Singh, Tushita Thakur, Nomita Chandhiok, Balwan Singh Dhillon
BACKGROUND & OBJECTIVES: In developed countries, efforts have been made to restrict episiotomy practice. However, in developing countries the episiotomy rates continue to be high. This study was conducted to evaluate the pattern of episiotomy use and its immediate complications among women delivering at tertiary level public hospitals in India. METHODS: Prospective data of all women undergoing vaginal delivery including instrumental delivery were collected daily from the labour room registers of the 18 tertiary care hospitals on a structured proforma...
April 2016: Indian Journal of Medical Research
Bernard T Haylen, Gayle Fischer, Dzung Vu, Kelly Tse
The vaginal vestibule has not been the subject of a dedicated journal article. Recent terminology has suggested its division into anterior and posterior components. The case for this division has not yet been assessed. Both components extend laterally from the hymen to the junction with the labia minora. The posterior vaginal vestibule is proposed to extend from the posterior aspect of the hymen to the anterior edge of the perineum whilst the anterior vestibule extends from the posterior aspect of the hymen to just below the clitoris...
July 4, 2016: Neurourology and Urodynamics
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