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Anal sphincter injury

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https://www.readbyqxmd.com/read/27881288/internal-anal-sphincter-clinical-perspective
#1
REVIEW
Lalit Kumar, Anton Emmanuel
OBJECTIVE: To summarise current knowledge of Internal anal sphincter. BACKGROUND: The internal anal sphincter (IAS) is the involuntary ring of smooth muscle in the anal canal and is the major contributor to the resting pressure in the anus. Structural injury or functional weakness of the muscle results in passive incontinence of faeces and flatus. With advent of new assessment and treatment modalities IAS has become an important topic for surgeons. This review was undertaken to summarise our current knowledge of internal anal sphincter and highlight the areas that need further research...
November 20, 2016: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/27865945/episiotomy-in-vacuum-assisted-delivery-affects-the-risk-of-obstetric-anal-sphincter-injury-a-systematic-review-and-meta-analysis
#2
REVIEW
Ninna S Lund, Lisa K G Persson, Hanna Jangö, Ditte Gommesen, Hanne B Westergaard
The risk of obstetric anal sphincter injury (OASIS) is increased in vacuum-assisted delivery. However, it remains unclear whether episiotomy may protect against OASIS in this type of delivery. The objective of this study was to assess whether mediolateral or lateral episiotomy affects the risk of OASIS in vacuum-assisted delivery among primiparous women. Data were found searching The PubMed, Cochrane library and Embase databases electronically. Studies investigating the risk of OASIS in vacuum-assisted delivery with and without the use of mediolateral or lateral episiotomy were considered for inclusion...
October 26, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27859542/midwives-management-during-the-second-stage-of-labor-in-relation-to-second-degree-tears-an-experimental-study
#3
Malin Edqvist, Ingegerd Hildingsson, Margareta Mollberg, Ingela Lundgren, Helena Lindgren
INTRODUCTION: Most women who give birth for the first time experience some form of perineal trauma. Second-degree tears contribute to long-term consequences for women and are a risk factor for occult anal sphincter injuries. The objective of this study was to evaluate a multifaceted midwifery intervention designed to reduce second-degree tears among primiparous women. METHODS: An experimental cohort study where a multifaceted intervention consisting of 1) spontaneous pushing, 2) all birth positions with flexibility in the sacro-iliac joints, and 3) a two-step head-to-body delivery was compared with standard care...
November 14, 2016: Birth
https://www.readbyqxmd.com/read/27783118/evaluation-of-training-programme-uptake-in-an-attempt-to-reduce-obstetric-anal-sphincter-injuries-the-support-programme
#4
Nadia Rahman, Latha Vinayakarao, Sangeeta Pathak, Dawn Minden, Louise Melson, Ella Vitue, A Pradhan
INTRODUCTION AND HYPOTHESIS: The objective was to assess the feedback from a quality improvement training programme to reduce obstetric anal sphincter injuries (OASIS). METHODS: Training sessions were organised that included evidence-based information on OASIS risk factors and training on models to measure perineal body length (PBL), perform episiotomies with standard and 60° fixed angle scissors (EPISCISSORS-60®), and measure post-delivery episiotomy suture angles with protractor transparencies...
October 25, 2016: International Urogynecology Journal
https://www.readbyqxmd.com/read/27761586/reducing-obstetric-anal-sphincter-injuries-using-perineal-support-our-preliminary-experience
#5
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
https://www.readbyqxmd.com/read/27722897/magnetic-resonance-imaging-mri-assisted-laparoscopic-anorectoplasty-for-imperforate-anus-a-single-center-experience
#6
Tina T Thomas, Daniel H Teitelbaum, Ethan A Smith, Jonathan R Dillman, Ranjith Vellody, Marcus D Jarboe
PURPOSE: Surgical procedures for high imperforate anus have ranged from the posterior sagittal anorectoplasty (PSARP) to laparoscopic-assisted anorectoplasty (LAARP). PSARP bisects the sphincter muscle complex, introducing muscle injury and scarring. LAARP uses a straight trocar to traverse an often non-linear sphincter muscle complex. MRI-assisted LAARP (MRI-LAARP) guides the neorectum precisely through the middle of the entire sphincter complex along its trajectory. We present our experience utilizing MRI intraoperatively during LAARP...
October 8, 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/27689916/a-novel-puborectalis-muscle-artificial-anal-sphincter-system-with-the-module-of-sensory-perception
#7
Hao Wu, Zhiwu Wang, Guozheng Yan, Wentian Jin, Shan Lu, Zerun Zhou
This article presents a novel puborectalis muscle artificial anal sphincter system (PM-AASS) with the module of sensory perception for treating severe faecal incontinence (FI). Due to the implantable feature of PM-AASS, this system applied low-power design and the total energy consumption could drop to 48.8 Ah/d. To reduce the injury of intestine and the pressure exerted on intestine, the actuator, including the structure of tings and the robot mechanism, of PM-AASS was presented and the middle ring was optimised...
February 2017: Journal of Medical Engineering & Technology
https://www.readbyqxmd.com/read/27682743/can-anal-sphincter-defects-be-identified-by-palpation
#8
Ka Lai Shek, Ixora Kamisan Atan, Hans Peter Dietz
OBJECTIVES: The aim of this study was to correlate clinical findings of anal sphincter defects and function with a sonographic diagnosis of significant sphincter defects. METHODS: This is an observational cross-sectional study on women seen 6 to 10 weeks after primary repair of obstetric anal sphincter injuries (OASIs). All patients underwent a standardized interview including the St Mark incontinence score, a digital rectal examination, and 3-/4-dimensional transperineal ultrasound imaging...
September 26, 2016: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/27676782/bladder-sphincter-disorders-and-quality-of-life-of-traumatic-brain-injury-tunisian-experience
#9
Mariem Rekik, Khaoula Achour, Anouer Abdallah, Sonia Lebib, Imen Miri, Fatima Zahra Ben Salah, Catherine Dziri
OBJECTIVE: The aim of our study was to assess the bladder and sphincter function after brain injury (BI) and to review their association with quality of life (QOL). MATERIAL/PATIENTS AND METHODS: We conducted a cross-sectional study, including patients referred to physical and rehabilitation medicine department at the Med Kassab Institute of Orthopedics. The initial gravity data were collected. The bladder-sphincter assessment included evaluation of the urine drain mode, the irritative disorders, obstructive disorders, disorders of transit and the existence of secondary anal lesions...
September 2016: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27643513/over-diagnosis-and-rising-rates-of-obstetric-anal-sphincter-injuries-oasis-time-for-reappraisal
#10
Dimos Sioutis, Ranee Thakar, Abdul H Sultan
OBJECTIVES: To identify the accuracy of clinically diagnosed OASIS using 3D endoanal ultrasound and compare symptoms and anal manometry measurements between those whose anal sphincters were adequately repaired to those who had persistent anal sphincter defects. METHODS: The endoanal scan images of women who sustained OASIS and attended the perineal clinic over a 10 year period (2003 - 2013) were re-analysed from data entered prospectively of women with clinically diagnosed and repaired OASIS...
September 19, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27613623/residual-defects-after-repair-of-obstetric-anal-sphincter-injuries-and-pelvic-floor-muscle-strength-are-related-to-anal-incontinence-symptoms
#11
Cristina Ros Cerro, Eva Martínez Franco, Giulio Aniello Santoro, Maria José Palau, Pawel Wieczorek, Montserrat Espuña-Pons
INTRODUCTION AND HYPOTHESIS: The aim was to analyze the correlation between residual anal sphincter (AS) defects and pelvic floor muscle (PFM) strength on anal incontinence (AI) in patients with a history of obstetric AS injuries (OASIS). METHODS: From September 2012 to February 2015, an observational study was conducted on a cohort of females who underwent repair of OASIS intrapartum. The degree of OASIS was scored intrapartum according to Sultan's classification...
September 9, 2016: International Urogynecology Journal
https://www.readbyqxmd.com/read/27589856/an-obstetric-sphincter-injury-risk-identification-system-osiris-is-this-a-clinically-useful-tool
#12
Sara S Webb, Karla Hemming, Madhi Y Khalfaoui, Tine Brink Henriksen, Sara Kindberg, Stine Stensgaard, Christine Kettle, Khaled M K Ismail
INTRODUCTION AND HYPOTHESIS: To establish the contribution of maternal, fetal and intrapartum factors to the risk of incidence of obstetric anal sphincter injuries (OASIS) and assess the feasibility of an OASIS risk prediction model based on variables available to clinicians prior to birth. METHODS: This was a population-based, retrospective cohort study using single-site data from the birth database of Aarhus University Hospital, Denmark. The participants were all women who had a singleton vaginal birth during the period 1989 to 2006...
September 2, 2016: International Urogynecology Journal
https://www.readbyqxmd.com/read/27557074/-incontinence-etiology-diagnostics-and-therapy
#13
Thomas Frieling
Fecal incontinence is defined by the unintentional loss of solid or liquid stool, and anal incontinence includes leakage of gas and / or fecal incontinence. Anal-fecal incontinence is not a diagnosis but a symptom. Many patients hide the problem from their families, friends, and even their doctors. Epidemiologic studies indicate a prevalence between 7-15 %, up to 30 % in hospitals and up to 70 % in longterm care settings. Anal-fecal incontinence causes a significant socio-economic burden. There is no widely accepted approach for classifying anal-fecal incontinence available...
August 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27523177/-rare-injury-of-perineum-and-anorectum-case-report
#14
M Lerch, M Peteja, A Zatloukal, P Ostruzska, P Ihnát, J Polovko, A Pelikán, P Zonča
UNLABELLED: Anorectal injuries, with the exception of iatrogenic damage, are rare. Considering the extensive range of causes and potential extent of damage, the diagnosis and treatment of these injuries requires an individual approach to every patient. Based on the extent of damage, the best way of treatment strategy has to be selected for successful treatment of the primary injury and elimination of frequent complications, especially fecal incontinence. The authors present a rare injury of the perineum and anorectum with anorectal sphincter damage in an elderly man after falling down from a stepladder...
2016: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/27497647/factors-associated-with-timing-of-return-to-intercourse-after-obstetric-anal-sphincter-injuries
#15
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
https://www.readbyqxmd.com/read/27463362/sacral-neuromodulation-for-faecal-incontinence-following-obstetric-sphincter-injury-outcome-of-percutaneous-nerve-evaluation
#16
Mona B Rydningen, Trond Dehli, Tom Wilsgaard, Rolv O Lindsetmo, Merethe Kumle, Mona Stedenfeldt, Stig Norderval
AIM: The purpose of this study was to assess the efficacy of percutaneous nerve evaluation (PNE) in women with faecal incontinence (FI) following obstetric anal sphincter injury and relate the outcomes to baseline factors with special emphasis on the extent of sphincter defect. METHOD: This was a prospective study at a tertiary colorectal referral unit at the University Hospital of North Norway conducted from 2012-2014. Sixty-three women underwent a three-week PNE using a tined lead and the Verify(®) external neurostimulator...
July 27, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/27451064/evaluation-of-long-term-pelvic-floor-symptoms-after-an-obstetric-anal-sphincter-injury-oasi-at-least-one-year-after-delivery-a-retrospective-cohort-study-of-159-cases
#17
D Desseauve, S Proust, C Carlier-Guerin, C Rutten, F Pierre, X Fritel
OBJECTIVES: The aim of this study was to assess long-term pelvic floor symptoms after an obstetric anal sphincter injury (OASI). METHODS: This retrospective cohort study included 237 cases of OASI (0.86% of deliveries) identified at Poitiers University Hospital between 2000 and 2011. Symptoms were assessed using validated self-administered questionnaires, including Female Pelvic Floor Questionnaire, Pescatori anal incontinence score, EuroQoL five-dimension score, and pain visual analogue scale (VAS)...
July 2016: Gynécologie, Obstétrique & Fertilité
https://www.readbyqxmd.com/read/27392390/effect-of-age-patient-s-sex-and-type-of-trauma-on-the-correlation-between-size-of-sphincter-defect-and-anal-pressures-in-posttraumatic-fecal-incontinence
#18
Sameh Hany Emile, Mohamed Youssef, Hossam Elfeki, Waleed Thabet, Hesham Elgendy, Waleed Omar, Wael Khafagy, Mohamed Farid
BACKGROUND: The physiologic assessment of anal sphincters in cases of posttraumatic fecal incontinence is a fundamental step in planning operative treatment. In this study, we evaluate the correlation between size of anal sphincter defect, anal pressures, and clinical symptoms in patients with posttraumatic fecal incontinence. We also investigate the impact of patients' age, sex, and type of trauma on this correlation. METHODS: Records of 70 patients fitting the study's eligibility criteria were collected retrospectively from the archives of Mansoura University Hospitals' colorectal surgery unit...
July 5, 2016: Surgery
https://www.readbyqxmd.com/read/27355329/galectin-1-induced-skeletal-muscle-cell-differentiation-of-mesenchymal-stem-cells-seeded-on-an-acellular-dermal-matrix-improves-injured-anal-sphincter
#19
Zhao Ding, Xiangui Liu, Xianghai Ren, Qiulei Zhang, Tingtao Zhang, Qun Qian, Weicheng Liu, Congqing Jiang
According to recent studies, mesenchymal stromal cells (MSCs) transplanted via local or tail vein injection can improve healing after anal sphincter injury (ASI) in animal models. However, the transplanted MSCs do not generate skeletal muscle that completely resembles the natural anal sphincter structure. In the present study, we investigated whether bone marrow (BM)-derived MSCs could be induced by Galectin-1 (Gal-1) to differentiate into skeletal muscle and whether the recellularization of an acellular dermal matrix (ADM) with skeletal muscle-differentiated MSCs represents a promising approach to restore ASI in a rat model...
May 2016: Discovery Medicine
https://www.readbyqxmd.com/read/27353096/-prevention-of-intraoperative-incidental-injuries-during-sphincter-preserving-surgery-for-rectal-cancer-and-management-of-postoperative-complication
#20
Fanghai Han, Hongming Li
Prevention of intraoperative incidental injuries during radical operation for rectal cancer and management of postoperative complication are associated with successful operation and prognosis of patients. This paper discusses how to prevent such intraoperative incidental injuries and how to manage postoperative complication. (1) Accurate clinical evaluation should be performed before operation and reasonable treatment decision should be made, including determination of the distance from transection to lower margin of the tumor, T and M staging evaluated by MRI, fascia invasion of mesorectum, metastasis of lateral lymph nodes, metastatic station of mesentery lymph node, association between levator ani muscle and anal sphincter, course and length of sigmoid observed by Barium enema, length assessment of pull-through bowel...
June 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
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