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Levator ani

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https://www.readbyqxmd.com/read/28323222/laparoscopic-nerve-preserving-sacropexy
#1
Alfredo Ercoli, Stefano Cosma, Francesca Riboni, Giuseppe Campagna, Paolo Petruzzelli, Daniela Surico, Saverio Danese, Giovanni Scambia, Chiara Benedetto
STUDY OBJECTIVE: to demonstrate our developed nerve preserving technique during laparoscopic sacropexy (LSP) for multicompartment pelvic organ prolapse. DESIGN: exemplificative case of our surgical procedure based on a multicentric experience consisting of more than 800 cases in 10 years without major intraoperative complications. Informed consent was taken from the subject, and the institutional review board approved this research. SETTING: public practice at Maggiore della Carità University Hospital, Novara; at Sant'Anna Hospital, City of Health and Science, University of Torino; at A...
March 17, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28321474/transvaginal-iliococcygeus-fixation-for-posthysterectomy-vaginal-vault-prolapse-repair
#2
Rodolfo Milani, Matteo Frigerio, Federico Spelzini, Stefano Manodoro
INTRODUCTION AND HYPOTHESIS: Posthysterectomy vaginal vault prolapse repair is a surgical challenge. Successful surgical management using native tissue can be achieved via the vaginal approach by iliococcygeus fascia fixation. However, although iliococcygeus fascia fixation is technically simple and has a low morbidity, it is not commonly performed. The aim of the video is to provide anatomic views and the surgical steps necessary to achieve successful transvaginal iliococcygeus fascia fixation for vaginal vault prolapse repair...
March 20, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28299781/architectural-differences-in-the-anterior-and-middle-compartments-of-the-pelvic-floor-of-young-adult-and-postmenopausal-females
#3
Yi Wu, Noshir F Dabhoiwala, Jaco Hagoort, Li-Wen Tan, Shao-Xiang Zhang, Wouter H Lamers
The pelvic floor guards the passage of the pelvic organs to the exterior. The near-epidemic prevalence of incontinence in women continues to generate interest in the functional anatomy of the pelvic floor. However, due to its complex architecture and poor accessibility, the classical 'dissectional' approach has been unable to come up with a satisfactory description, so that many aspects of its anatomy continue to raise debate. For this reason, we opted for a 'sectional' approach, using the Chinese Visible Human project (four females, 21-35 years) and the Visible Human Project (USA; one female, 59 years) datasets to investigate age-related changes in the architecture of the anterior and middle compartments of the pelvic floor...
March 16, 2017: Journal of Anatomy
https://www.readbyqxmd.com/read/28282764/influence-of-difficulty-of-instrumentation-with-vacuum-on-the-rate-of-levator-ani-muscle-avulsion-identified-by-3-4%C3%A2-d-transperineal-ultrasound
#4
José Antonio García Mejido, Paloma De la Fuente Vaquero, Ana Fernández Palacín, Adriana Aquise Pino, María José Bonomi Barby, José Antonio Sainz Bueno
OBJECTIVES: Evaluation of the influence of difficulty of instrumentation with vacuum on the rate of levator ani muscle (LAM) avulsions. MATERIALS AND METHODS: Prospective observational study with 86 nulliparous women with at term gestation who required instrumentation with vacuum to complete fetal extraction. After every delivery, each explorer reported the number of vacuum tractions needed to complete fetal extraction, as well as the subjective complexity of the instrumentation...
March 1, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28277469/correlation-between-transperineal-3-dimensional-ultrasound-measurements-of-levator-hiatus-and-female-sexual-function
#5
Serdar Aydin, Rabia Zehra Bakar, Çağri Arioğlu Aydin, Seda Ateş
OBJECTIVE: The aim of this study is to investigate the association of sexual functions with levator hiatus biometry measurements and levator ani muscle defect. METHODS: In 62 heterosexual, sexually active premenopausal women without pelvic floor disorders or urinary incontinence, 3-dimensional transperineal ultrasound imaging was used. Two 3-dimensional volumes were recorded, one at rest and one on Valsalva maneuver. Levator biometry measurements and levator defect were evaluated in an axial plane...
March 9, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28265140/measurement-the-thickness-of-the-transverse-abdominal-muscle-in-different-tasks
#6
Ling Pang, Liquan Yin, Kimiko Tajiri, Ming Huo, Hitoshi Maruyama
[Purpose] This study examined the measurement of the thickness of the transverse abdominal muscle in different tasks. [Subjects and Methods] The subjects were eleven healthy adult females. Thicknesses of transverse abdominal muscle were measured in seven tasks in the supine position. The tasks were: 1) Resting state, 2) Maximal contraction of transverse abdominal muscle, 3) Maximal contraction of levator ani muscle, 4) Maximal simultaneous contraction of both transverse abdominal muscle and levator ani muscle, 5) Maximal simultaneous contraction of both transverse abdominal muscle and levator ani muscle with front side resistance added to both knee, 6) Maximal simultaneous contraction of both transverse abdominal muscle and levator ani muscle with diagonal resistance added to both knees, and 7) Maximal simultaneous contraction of both transverse abdominal muscle and levator ani muscle with lateral resistance added to both knees...
February 2017: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/28252314/-current-state-of-transvaginal-meshes-by-resolution-of-pelvic-organ-prolapse
#7
J Jírová, M Pán
OBJECTIVE: Treatment of pelvic organs prolapse with transvaginal mesh kits represents nowadays a widespread surgical method, which partially replaced classic operations due to high success rate and low count of recurrences. Just like any other surgical method, the placement of transvaginal mesh is linked with occurrence of complications. In this article we attempt to review the more and less known facts about trans-vaginal meshes, their efficacy, count of recurrence and the spectrum of complications and we try to compare this technique with traditional surgical methods used to treat pelvic organs prolapse (without graft materials)...
2017: Ceská Gynekologie
https://www.readbyqxmd.com/read/28236365/a-longitudinal-follow-up-of-pelvic-floor-biometry-what-are-the-factors-affecting-it
#8
Symphorosa Sc Chan, Rachel Yk Cheung, L L Lee, Tony Kh Chung
OBJECTIVE: To evaluate pelvic floor biometry 3-5 years after first delivery. The effect of a second delivery and mode of delivery were studied. METHODS: Women, who had been assessed at first pregnancy, 8 weeks postnatally and one year after delivery, were invited for follow-up. Positions of the bladder neck (BN), cervix, anorectal junction and hiatal area (HA), were evaluated by translabial ultrasound. The effects of parity, mode of delivery and levator ani muscle (LAM) avulsion were studied...
February 25, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28224270/intrapartal-pelvic-floor-protection-a-pragmatic-and-interdisciplinary-approach-between-obstetrics-and-urogynecology
#9
Markus Huebner, Sara Y Brucker, Ralf Tunn, Gert Naumann, Christl Reisenauer, Harald Abele
Pelvic floor protection is an issue of increasing relevance. This article sought to summarize the session at last year's annual meeting of the German Society of Gynecology and Obstetrics (DGGG) in Stuttgart (10/2016) called "Urogynecology 2020-what is the optimal rate of cesarean section-does urogynecology have to deal with Obstetrics?". The main focus was set on the two important anatomical structures, the levator ani muscle and the anal sphincters. Operative vaginal delivery, epidural anesthesia, and episiotomy are subject to discussion...
February 21, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28154915/prolapse-symptoms-are-associated-with-abnormal-functional-anatomy-of-the-pelvic-floor
#10
Zeelha Abdool, Hans Peter Dietz, Barend Gerhardus Lindeque
INTRODUCTION AND HYPOTHESIS: The etiology of pelvic organ prolapse (POP) likely includes over-distension or tears (avulsion) of the levator ani muscle. However, there is a lack of studies evaluating the association between symptoms of POP and these factors. This study was designed to determine the association between POP symptoms and clinical prolapse stage on the one hand, and pelvic floor functional anatomy on the other hand. METHODS: This prospective observational study included 258 patients seen at a tertiary urogynecological unit with symptoms of POP as defined by pertinent ICIQ questions...
February 2, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28144213/abdominal-approaches-to-rectal-prolapse
#11
REVIEW
Kyla Joubert, Jonathan A Laryea
Rectal prolapse is a debilitating condition with a complex etiology. Symptoms are most commonly prolapse of the rectum and pain with bowel movements or straining, with worsening fecal incontinence over time due to progressive stretching of the anal sphincters. Physical findings are fairly consistent from patient to patient-most notably diastasis of the levator ani muscles, deep pouch of Douglas, redundant sigmoid colon, a mobile mesorectum, and occasionally a solitary rectal ulcer. Evaluation includes a physical exam or imaging demonstrating the prolapse, and evaluating for other causes of pelvic floor dysfunction...
February 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28134704/diagnostic-accuracy-and-clinical-implications-of-translabial-ultrasound-for-the-assessment-of-levator-ani-defects-and-levator-ani-biometry-in-women-with-pelvic-organ-prolapse-a-systematic-review
#12
Kim J B Notten, Tineke F M Vergeldt, Sander M J van Kuijk, Mirjam Weemhoff, Jan-Paul W R Roovers
OBJECTIVE: The aim of this study was to assess the diagnostic accuracy and clinical implications of translabial 3-dimensional (3D) ultrasound for the assessment of levator ani defects and biometry in women with pelvic organ prolapse (POP). METHODS: We performed a systematic literature search through computerized databases including MEDLINE (via PubMed), EMBASE (via OvidSP), and the Cochrane Library using both medical subject headings and text terms from January 1, 2003, to December 25, 2015...
January 27, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28125816/comparative-anatomy-of-the-ovine-and-female-pelvis
#13
Iva Urbankova, Katarina Vdoviakova, Rita Rynkevic, Nikhil Sindhwani, Dries Deprest, Andrew Feola, Paul Herijgers, Ladislav Krofta, Jan Deprest
BACKGROUND: Pelvic organ prolapse affects half of vaginally parous women. Several animal models are used to study its pathophysiology and treatment. Sheep are interesting because they develop spontaneously prolapse with similar risk factors as women and can be used for vaginal surgery. This study describes ovine pelvis anatomy and compares it to women's pelvis to provide anatomical tools for translational researchers. METHODS: MRI, pelvic dissections, and histology were used for detailed macro- and microscopic analysis of relevant anatomical structures in 6 nulliparous ewes...
January 27, 2017: Gynecologic and Obstetric Investigation
https://www.readbyqxmd.com/read/28117880/intrapartum-predictors-of-maternal-levator-ani-injury
#14
Jessica Caudwell-Hall, Ixora Kamisan Atan, Andrew Martin, Rodrigo Guzman Rojas, Susanne Langer, Kalai Shek, Hans Peter Dietz
INTRODUCTION: Damage to the pelvic floor during vaginal childbirth is common, and may take the form of levator avulsion or irreversible over-distention of the levator hiatus (microtrauma). Such trauma is a major risk factor for pelvic organ prolapse later in life. In this study we aimed to identify intrapartum risk factors for levator trauma. MATERIAL AND METHODS: This is a retrospective analysis of data obtained in two perinatal studies on primiparous women. Between 2005 and 2014, 1148 patients carrying an uncomplicated singleton pregnancy in the late third trimester were seen for 4D pelvic floor ultrasound and an interview...
January 24, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28078670/levator-ani-muscle-avulsion-is-a-risk-factor-for-vaginal-pessary-expulsion-within-1-year-for-pelvic-organ-prolapse
#15
Rachel Yau Kar Cheung, Jacqueline Ho Sze Lee, Lai Loi Lee, Tony Kwok Hung Chung, Symphorosa Shing Chee Chan
OBJECTIVE: The aim of this study was to investigate whether presence of levator ani muscle (LAM) avulsion was associated with expulsion of vaginal pessary for women with pelvic organ prolapse (POP). METHODS: This prospective observational study recruited consecutive women with symptomatic POP. Vaginal pessary was offered and offline analysis of the 3D/4D transperineal ultrasound volume data of women was performed. Volume acquisition had been performed before pessary insertion...
January 12, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28067748/levator-ani-muscle-defects-in-patients-with-surgical-failure
#16
Allison M Wyman, Kristie A Greene, Renee Bassaly, Lindsey Hahn, Simon Patton, Branko Miladinovic, Lennox Hoyte
INTRODUCTION: The objective of the study was to use a well-described system of measuring levator ani (LA) muscle defects from magnetic resonance images to evaluate whether major defects are correlated to an increased risk of surgical failure. METHODS: A retrospective cohort study performed on patients who underwent laparoscopic uterosacral ligament suspension from 2010 to 2012. Surgical failure was defined as a composite score of anatomic bulge beyond the hymen with sensation of bulge or repeat treatment of prolapse via pessary or surgery by 1-year follow-up...
March 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28042624/literature-review-of-factors-affecting-continence-after-radical-prostatectomy
#17
Dalibor Pacik, Michal Fedorko
Radical prostatectomy (RP) is the most common cause of stress urinary incontinence (UI) in men. Several anatomic structures affect or may affect urinary continence - urethral sphincter, levator ani muscle, puboprostatic ligaments, bladder neck, endopelvic fascia, neurovascular bundle - and understanding of the anatomy of pelvic floor and urethra is crucial for satisfactory functional outcome of the procedure. Surgical techniques implemented to improve continence rates include nerve-sparing procedure, bladder neck preservation/plication, urethral length preservation, musculofascial reconstruction, puboprostatic ligaments preservation or seminal vesicle preservation...
January 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/28027607/third-or-fourth-degree-intrapartum-anal-sphincter-tears-are-associated-with-levator-ani-avulsion-in-primiparas
#18
Dan V Valsky, Sarah M Cohen, Michal Lipschuetz, Drorith Hochner-Celnikier, Hagit Daum, Itai Yagel, Simcha Yagel
OBJECTIVES: We evaluated primiparous women with clinically diagnosed third- and fourth-degree and anal sphincter tears, to evaluate the rate of levator ani muscle injury compared to primiparous women without sphincter tears. METHODS: Primiparous women delivering in our maternity ward with intrapartum diagnoses of third- or fourth-degree anal sphincter tears, repaired by the overlapping technique, were recruited to undergo 3-dimensional transperineal sonography of the pelvic floor anatomy, including the anterior and posterior compartments...
April 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/27924378/recurrence-risk-is-associated-with-preoperatively-advanced-prolapse-stage-is-there-a-difference-between-women-with-stage-2-and-those-with-stage-3-or-4-cystocele
#19
Tineke F M Vergeldt, Kim J B Notten, Kirsten B Kluivers, Mirjam Weemhoff
INTRODUCTION AND HYPOTHESIS: Pelvic organ prolapse (POP) recurrence after surgery is a major problem. POP that is more advanced preoperatively is associated with a higher risk of recurrence postoperatively. We hypothesized that women with a stage 2 cystocele differ from those with a stage 3 or 4 cystocele. The aim of this study was to compare the baseline characteristics of women with mild and those with more advanced cystocele. METHODS: Patients had participated in one of two multicenter prospective cohort studies on women undergoing conventional anterior colporrhaphy without previous POP surgery...
December 6, 2016: International Urogynecology Journal
https://www.readbyqxmd.com/read/27920855/aggressive-angiomyxoma-case-report-and-review-of-the-literature
#20
John C Benson, Scott Gilles, Tina Sanghvi, James Boyum, Eric Niendorf
A 47-year-old female presented to clinic with a 5-year history of a left buttock mass. The patient's hemoglobin was low (9.7 g/dL); laboratory analysis was otherwise unremarkable. Ultrasound of the left gluteal region demonstrated a heterogeneous vascular solid lesion. Magnetic resonance and computed tomography imaging showed an enhancing mass extending from the left ischioanal fossa through the levator ani muscle into the pelvis. Biopsy revealed bland-appearing spindle-shaped cells positive for estrogen and progesterone receptors, consistent with an aggressive angiomyxoma...
December 2016: Radiology case reports
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