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Anal sphincter injury

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https://www.readbyqxmd.com/read/28523401/functional-and-quality-of-life-outcomes-following-obstetric-anal-sphincter-injury-oasi-does-the-grade-of-injury-affect-outcomes
#1
Lisa Ramage, Clarence Yen, Shengyang Qiu, Constantinos Simillis, Christos Kontovounisios, Paris Tekkis, Emile Tan
INTRODUCTION AND HYPOTHESIS: The aim of this study was to compare functional and quality of life data in patients with increasing grades of obstetric anal sphincter injury (OASI) presenting to a tertiary colorectal pelvic floor clinic within 24 months of delivery. METHODS: Prospective data were collected from the patients for the period 2009-2016 and included data on functional outcomes and motor anorectal manometry parameters. The instruments used for the evaluation of functional outcomes were the Birmingham Bowel and Urinary Symptoms Questionnaire, the Wexner Incontinence Score, Short Form 36, and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire...
May 18, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28523399/anal-sphincter-injury-in-vaginal-deliveries-complicated-by-shoulder-dystocia
#2
Mark P Hehir, Zachary Rubeo, Karen Flood, Anne H Mardy, Colm O'Herlihy, Peter C Boylan, Mary E D'Alton
INTRODUCTION AND HYPOTHESIS: Shoulder dystocia is an obstetric emergency that occurs in 0.2-3% of all cephalic vaginal deliveries. We hypothesized that because of the difficult nature of deliveries complicated by shoulder dystocia, the condition may be associated with anal sphincter injury. We sought to identify risk factors for obstetric anal sphincter injury in women with shoulder dystocia. METHODS: This retrospective analysis included all cases of shoulder dystocia from 2007 to 2011 at two large tertiary referral centers, in the USA and Ireland...
May 18, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28489924/neonatal-and-maternal-outcomes-of-successful-manual-rotation-to-correct-malposition-of-the-fetal-head-a-retrospective-and-prospective-observational-study
#3
Nicola Tempest, Naomi McGuinness, Steven Lane, Dharani K Hapangama
OBJECTIVE: To evaluate the neonatal and maternal outcomes associated with successful operative vaginal births assisted by manual rotation. DESIGN: Prospective and retrospective observational study. SETTING: Delivery suite in a tertiary referral teaching hospital in England. POPULATION: A cohort of 2,426 consecutive operative births, in the second stage of labour, complicated with malposition of the fetal head during 2006-2013...
2017: PloS One
https://www.readbyqxmd.com/read/28477150/the-optimal-angle-of-the-mediolateral-episiotomy-at-crowning-of-the-head-during-labor
#4
Shimon Ginath, Osnat Elyashiv, Eran Weiner, Ron Sagiv, Jacob Bar, Joseph Menczer, Michal Kovo, Alexander Condrea
INTRODUCTION AND HYPOTHESIS: The aim of the mediolateral episiotomy incision is to increase the diameter of the soft tissue of the vaginal outlet to facilitate birth and to prevent vaginal tears. Episiotomy angles that are too narrow and close to the midline increase the risk of obstetric anal sphincter injuries. In order to determine the optimal angle of the episiotomy, we assessed the changes in the angles of episiotomy lines marked during the first stage of labor and measured at the time of crowning of the head...
May 5, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28474610/blunt-rectal-trauma-case-report-and-literature-review
#5
Michele Marini, Giorgio Fratus, Pierluigi D'Amore, Fabio Tagliabue, Pierpaolo Mariani, Luisella Spinelli, Lorenzo Novellino
Blunt colorectal traumas are rare clinical entities with a challenging diagnostic and operative management. We describe the case of a 40-year-old man, victim of an accidental fall from a height of four meters who was subsequently diagnosed to have a blunt rectal trauma. A first CT scan showed fracture of the skull and an extensive subcutaneous haematoma of the lower back associated with a fracture of the left transverse processes of lumbar vertebrae. No other visceral abdominal lesions were recognized and patient was admitted to our department for observational studies...
December 20, 2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28467760/obstetric-anal-sphincter-injuries-oasis-in-israel-a-review-of-the-incidence-and-risk-factors
#6
REVIEW
Shimon Ginath, Yossi Mizrachi, Jacob Bar, Alexander Condrea, Michal Kovo
Obstetric anal sphincter injuries (OASIs) following vaginal deliveries are the main reason for subsequent development of anal incontinence in women. The diagnosis of such tears is crucial for treating and preventing such a grave sequela. The reported rate of OASIs in Israel was between 0.1% and 0.6%, out of all vaginal births, which is 10-fold lower than that reported in Europe and the United States. Structured hands-on training in repair of OASIs in seven medical centers in Israel significantly increased the detection rate of third-degree perineal tears...
April 28, 2017: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/28445798/episiotomy-what-angle-do-you-cut-to-the-midline
#7
Kenneth Ma, Louise Byrd
OBJECTIVE: Although episiotomies are the commonest obstetric procedure performed the technique of performing one varies amongst obstetricians and midwives. The angle of episiotomy to the midline in particular has been shown to influence the risk of developing obstetric anal sphincter injuries (OASIS). In order to identify the differences in technique and to identify targets for training we undertook a practice survey of episiotomies to analyse the differences in technique between grades of obstetricians and midwives...
April 11, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28432678/anal-metastasis-of-rectal-cancer-adenocarcinoma-of-squamous-cells-a-case-report-and-literature-review
#8
Shun Sasaki, Masahiko Sugiyama, Yu Nakaji, Ryota Nakanishi, Yuichiro Nakashima, Hiroshi Saeki, Eiji Oki, Yoshinao Oda, Yoshihiko Maehara
Anal metastasis of colorectal cancer is very rare and is usually associated with a history of anal disease, including anal fistula, fissure, hemorrhoidectomy, and anastomotic injury. We report a case of rectal cancer with a synchronous anal metastasis consisting of adenocarcinoma of squamous cells without a history of anal disease. A 60-year-old woman had a chief complaint of melena. She had a 1.5-cm anal tumor on the perianal skin, and a Bollman type 2 rectal tumor on the Ra portion was found on colonoscopy...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28430725/awareness-regarding-perineal-protection-obstetric-anal-sphincter-injury-and-episiotomy-among-obstetrics-and-gynecology-residents-effects-of-an-educational-workshop
#9
Anna M Stecher, Jennifer Yeung, Catrina C Crisp, Rachel N Pauls
OBJECTIVES: Appropriate perineal protection may reduce rates of obstetric anal sphincter injuries (OASIS). We sought to investigate the knowledge and attitudes of obstetrics and gynecology residents concerning perineal protection, OASIS, and episiotomy before and after an educational workshop. METHODS: This was an institutional review board-approved cross-sectional survey study of obstetrics and gynecology residents. Two experts in perineal protection, whose methods have been shown to reduce OASIS by 50%, provided 1 week of education...
April 20, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28424479/wnt-%C3%AE-catenin-signaling-pathway-a-major-player-in-the-injury-induced-fibrosis-and-dysfunction-of-the-external-anal-sphincter
#10
M Raj Rajasekaran, Sadhana Kanoo, Johnny Fu, Valmik Bhargava, Ravinder K Mittal
Wnt-β catenin is an important signaling pathway in the genesis of fibrosis in many organ systems. Our goal was to examine the role of Wnt pathway in the external anal sphincter (EAS) injury-related fibrosis and muscle dysfunction. New Zealand White female rabbits were subjected to surgical EAS myotomy and administered local injections of either a Wnt antagonist (sFRP-2; daily for 7 days) or saline. Anal canal pressure and EAS length-tension (L-T) were measured for 15 weeks after which the animals were sacrificed...
April 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28416052/-a-38-year-old-woman-with-an-anovaginal-fistula-after-consensual-penile-anal-intercourse
#11
Lærke Albertsen, Heidi Beate Christensen
In this case report a 38-year-old woman was admitted to hospital with anal bleeding and perianal pain after a consensual vaginal intercourse followed by an anal intercourse during which she felt a sudden profound pain. Nine days later she was diagnosed with an anovaginal fistula. A diverting sigmoideostomy was performed, and spontaneous healing was awaited. Rectovaginal fistula without concomitant anal sphincter injury as a result of consensual penile anal intercourse is an extremely rare occurrence, described only once previously...
April 10, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28409235/anal-incontinence-after-two-vaginal-deliveries-without-obstetric-anal-sphincter-rupture
#12
Lisa K G Persson, Abelone Sakse, Jens Langhoff-Roos, Hanna Jangö
PURPOSE: To evaluate prevalence and risk factors for long-term anal incontinence in women with two prior vaginal deliveries without obstetric anal sphincter injury (OASIS) and to assess the impact of anal incontinence-related symptoms on quality of life. METHODS: This is a nation-wide cross-sectional survey study. One thousand women who had a first vaginal delivery and a subsequent delivery, both without OASIS, between 1997 and 2008 in Denmark were identified in the Danish Medical Birth Registry...
April 13, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28389490/diagnosis-and-repair-of-perineal-injuries-knowledge-before-and-after-expert-training-a-multicentre-observational-study-among-palestinian-physicians-and-midwives
#13
Kaled Zimmo, Katariina Laine, Åse Vikanes, Erik Fosse, Mohammed Zimmo, Hadil Ali, Ranee Thakar, Abdul H Sultan, Sahar Hassan
OBJECTIVE: To assess whether a 2 days training with experts teaching on diagnosis and repair of perineal injuries among Palestinian midwives and physicians could change their level of knowledge towards the correct diagnosis and treatment. STUDY DESIGN: Multicentre observational study. SETTING: Obstetric departments in 6 government Palestinian hospitals. PARTICIPANTS: All physicians and midwives who attended the training...
April 7, 2017: BMJ Open
https://www.readbyqxmd.com/read/28363187/the-impact-of-anal-sphincter-injury-on-perceived-body-image
#14
David Iles, Rabia Khan, Kristina Naidoo, Rohna Kearney, Jenny Myers, Fiona Reid
OBJECTIVE: Obstetric anal sphincter injury is common but the effect on body image is unreported. The aim of this study was to explore patient perceived changes in body image and other psychological aspects in women attending a perineal follow-up clinic. STUDY DESIGN: This retrospective study analysed women's responses to a self-reported questionnaire. Consecutive women with anal sphincter injury who attended a United Kingdom Maternity Hospital perineal follow-up clinic between January 1999 and January 2012 were identified and the records obtained and reviewed...
May 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28342158/the-incidence-of-and-risk-factors-for-a-repeat-obstetric-anal-sphincter-injury-oasis-in-the-vaginal-birth-subsequent-to-a-first-episode-of-oasis-a-hospital-based-cohort-study
#15
Angeliki Antonakou, Dimitrios Papoutsis, Karen Henderson, Zahid Qadri, Andrew Tapp
PURPOSE: To identify the incidence of and risk factors for a repeat obstetric anal sphincter injury (OASIS) in women who sustained an OASIS in their first vaginal delivery and have a subsequent vaginal birth. METHODS: Data were collected retrospectively for women having had singleton cephalic presentation vaginal deliveries between 2007 and 2015. Women with breech deliveries, stillbirths, foetal congenital abnormalities and multiple pregnancies were excluded. RESULTS: Over the study period, we identified 11,191 women who had a first vaginal birth, of which 603 (5...
March 24, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28331968/choice-of-mode-of-delivery-in-a-subsequent-pregnancy-after-oasi-a-survey-among-dutch-gynecologists
#16
Judith J A E Donners, Kirsten B Kluivers, Jan W de Leeuw, Jeroen van Dillen, Sander M J van Kuijk, Mirjam Weemhoff
INTRODUCTION AND HYPOTHESIS: National and international guidelines do not provide clear recommendations on the mode of delivery in a subsequent pregnancy after obstetric anal sphincter injury (OASI). The aim of this study was to investigate the opinion of gynecologists in The Netherlands on this choice and the extent to which this choice is affected by the gynecologist's characteristics. METHODS: Of 973 gynecologists sent a questionnaire seeking their opinion on the mode of delivery in 16 different case descriptions, 234 (24%) responded...
March 22, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28321472/feasibility-and-benefits-of-the-ewe-as-a-model-for-vaginal-surgery-training
#17
Yohan Kerbage, Géraldine Giraudet, Chrystèle Rubod, Charles Garabedian, Géraldine Rivaux, Michel Cosson
INTRODUCTION AND HYPOTHESIS: The objective was to evaluate the ewe as an animal model for teaching and training in vaginal surgery. METHODS: Twenty-nine postgraduate surgeons attended a training course on vaginal prolapse surgery. After a review of human and sheep anatomy, the participants performed transvaginal meshes, vaginal hysterectomy, SSLF (Richter), and OAS repair in ewes and human cadavers. Participants completed questionnaires on the whole course. RESULTS: Questionnaires showed the significant superiority of ewes over human cadavers for all items evaluated regarding surgical dissections...
March 20, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28267010/regenerating-the-anal-sphincter-cytokines-stem-cells-or-both
#18
Li Sun, Zhuojun Xie, Mei Kuang, Marc Penn, Margot S Damaser, Massarat Zutshi
BACKGROUND: Healing of an anal sphincter defect at a time distant from injury is a challenge. OBJECTIVE: We aimed to investigate whether re-establishing stem cell homing at the site of an anal sphincter defect when cytokine expression has declined using a plasmid engineered to express stromal derived factor 1 with or without mesenchymal stem cells can improve anatomic and functional outcome. DESIGN: This was a randomized animal study. SETTINGS: Thirty-two female age- and weight-matched Sprague Dawley rats underwent 50% excision of the anal sphincter complex...
April 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28211186/sacral-neuromodulation-compared-with-injection-of-bulking-agents-for-faecal-incontinence-following-obstetric-anal-sphincter-injury-a-randomized-controlled-trial
#19
M Rydningen, T Dehli, T Wilsgaard, A Rydning, M Kumle, R O Lindsetmo, S Norderval
AIM: The purpose of this trial was to compare the effectiveness of sacral neuromodulation (SNM) with a submucosal injection of collagen (Permacol®) in women with faecal incontinence following obstetric anal sphincter injury (OASIS). METHOD: This single-blinded randomized controlled trial at two hospital units in Norway included women with faecal incontinence following OASIS. Eligible women who had had a successful percutaneous nerve evaluation were randomly assigned to SNM or Permacol®...
May 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28202245/recurrent-obstetric-anal-sphincter-injury-and-the-risk-of-long-term-anal-incontinence
#20
Hanna Jangö, Jens Langhoff-Roos, Susanne Rosthøj, Abelone Sakse
BACKGROUND: Women with an obstetric anal sphincter injury are concerned about the risk of recurrent obstetric anal sphincter injury in their second pregnancy. Existing studies have failed to clarify whether the recurrence of obstetric anal sphincter injury affects the risk of anal and fecal incontinence at long-term follow-up. OBJECTIVE: The objective of the study was to evaluate whether recurrent obstetric anal sphincter injury influenced the risk of anal and fecal incontinence more than 5 years after the second vaginal delivery...
February 13, 2017: American Journal of Obstetrics and Gynecology
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