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Levator ani

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https://www.readbyqxmd.com/read/28762179/vaginal-laxity-what-does-this-symptom-mean
#1
Hans Peter Dietz, Martyna Stankiewicz, Ixora Kamisan Atan, Caroline Wanderley Ferreira, Maciej Socha
INTRODUCTION AND HYPOTHESIS: Vaginal laxity is a poorly understood symptom of pelvic floor dysfunction. The purpose of this study was to investigate associations between the symptom of vaginal laxity and its bother on the one hand, and demographic data, other symptoms, and findings on examination on the other hand. METHODS: This was a retrospective observational study at a tertiary urogynecological unit. A total of 337 patients were seen for a standardized interview, clinical examination (ICS POP-Q) and 4D translabial ultrasonography...
July 31, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28709583/interactions-among-pelvic-organ-protrusion-levator-ani%C3%A2-descent-and-hiatal-enlargement-in-women-with-and-without-prolapse
#2
Anne G Sammarco, Lahari Nandikanti, Emily K Kobernik, Bing Xie, Alexandra Jankowski, Carolyn W Swenson, John O L DeLancey
BACKGROUND: Pelvic organ prolapse has 2 components: (1) protrusion of the pelvic organs beyond the hymen; and (2) descent of the levator ani. The Pelvic Organ Prolapse Quantification system measures the first component, however, there remains no standard measurement protocol for the second mechanism. OBJECTIVE: We sought to test the hypotheses that: (1) difference in the protrusion area is greater than the area created by levator descent in prolapse patients compared with controls; and (2) prolapse is more strongly associated with levator hiatus compared to urogenital hiatus...
July 11, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28699286/clinical-anatomy-of-fecal-incontinence-in-women
#3
REVIEW
Priyanka K Kadam-Halani, Lily A Arya, Uduak U Andy
Fecal incontinence is a devastating condition that has a severe impact on quality of life. This condition disproportionately affects women and its incidence is increasing with the aging United States population. Fecal continence is maintained by coordination of a functioning anal sphincter complex, intact sensation of the anorectum, rectal compliance, and the ability to consciously control defecation. Particularly important are the puborectalis sling of the levator ani muscle complex and intact innervation of the central and peripheral nervous systems...
July 12, 2017: Clinical Anatomy
https://www.readbyqxmd.com/read/28698071/bilateral-plication-of-the-puborectal-muscles-a-new-surgical-concept-for-treating-vulvar-widening
#4
M Serrand, A Lefebvre, E Delorme
OBJECTIVES: This study describe a new myorraphy technique by bilateral plication of the puborectalis bundles (PRP) of the levator ani muscle to treat vulvovaginal widening. The aim of this work was to report our preliminary experience in terms of morbidity and results (anatomical and functional) in the short and medium term. MATERIALS AND METHODS: This single centre retrospective study concerned 69 women who underwent PRP between January 2011 and December 2014...
July 8, 2017: Journal of gynecology obstetrics and human reproduction
https://www.readbyqxmd.com/read/28676358/anatomy-and-physiology-of-the-pelvic-floor
#5
REVIEW
Sarah M Eickmeyer
Understanding the anatomic relationship of the pelvic floor muscles with the pelvic girdle, spine, and hips aids the rehabilitation provider in diagnosis, management, and appropriate referrals. The bony anatomy of the pelvic girdle consists of 3 bones and 3 joints. The pelvic floor muscles are comprised mainly of the levator ani muscles with somatic innervation from the lumbosacral plexus. The bony and muscular pelvis is highly interconnected to the hip and gluteal musculature, which together provide support to the internal organs and core muscles...
August 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/28673060/urethral-closure-pressure-at-stress-a-predictive-measure-for-the-diagnosis-and-severity-of-urinary-incontinence-in-women
#6
Anne-Cécile Pizzoferrato, Arnaud Fauconnier, Xavier Fritel, Georges Bader, Philippe Dompeyre
PURPOSE: Maintaining urinary continence at stress requires a competent urethral sphincter and good suburethral support. Sphincter competence is estimated by measuring the maximal urethral closure pressure at rest. We aimed to study the value of a new urodynamic measure, the urethral closure pressure at stress (s-UCP), in the diagnosis and severity of female stress urinary incontinence (SUI). METHODS: A total of 400 women without neurological disorders were included in this observational study...
June 2017: International Neurourology Journal
https://www.readbyqxmd.com/read/28664535/characterising-levator-ani-muscle-stiffness-pre-and-post-childbirth-in-european-and-polynesian-women-in-new-zealand-a-pilot-study
#7
Jennifer A Kruger, Stephanie C Budgett, Vivien Wong, Poul M F Nielsen, Martyn P Nash, Jackie Smalldridge, Lynsey M Hayward, Tania Yu Tian, Andrew J Taberner
INTRODUCTION: The influence of levator-ani muscles on second stage labour is poorly understood. The ability of these muscles to stretch without damage may affect birth outcomes, but little is known about material properties, effects of pregnancy and/or ethnicity on levator-ani stiffness. There are strong associations between muscle damage and subsequent pelvic floor disorders. This study aimed to quantify levator-ani muscle stiffness during the third trimester of pregnancy and postpartum in European and Polynesian women...
June 30, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28624916/interethnic-variation-in-pelvic-floor-morphology-in-women-with-symptomatic-pelvic-organ-prolapse
#8
Zeelha Abdool, Hans Peter Dietz, Barend Gerhardus Lindeque
INTRODUCTION AND HYPOTHESIS: There is a lack of epidemiological studies evaluating female pelvic organ prolapse in developing countries. Current studies have largely focused on women of white ethnicity. This study was designed to determine interethnic variation in pelvic floor functional anatomy, namely, levator hiatal distensibility and pelvic organ descent, in women with symptomatic pelvic organ prolapse in a multi-ethnic South African population. METHODS: This prospective observational study included 258 consecutive women referred for pelvic organ prolapse assessment and management at a tertiary urogynaecological clinic...
June 17, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28620795/levator-ani-defects-and-the-severity-of-symptoms-in-women-with-anterior-compartment-pelvic-organ-prolapse
#9
Sissel H Oversand, Anne C Staff, Leiv Sandvik, Ingrid Volløyhaug, Rune Svenningsen
INTRODUCTION AND HYPOTHESIS: The aims of this study were to evaluate the prevalence of levator ani muscle (LAM) avulsions in a selected cohort of patients with primary anterior compartment pelvic organ prolapse (POP) and to assess whether LAM avulsions, as an independent factor, affect the degree of POP symptoms and sexual dysfunction. Additionally, clinical and demographic variables of women with and those without avulsions were compared. METHODS: We carried out a cross-sectional analysis of a prospective cohort study including 197 women scheduled for anterior compartment POP surgery...
June 15, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28598517/impact-of-episiotomy-on-the-urogenital-hiatus-using-transperineal-ultrasound
#10
Jordi Cassadó Garriga, Ana Carmona Ruiz, Antoni Pessarrodona Isern, Monica Rodríguez Carballeira, Esther Esteve Serena, Pablo García Manau, Marta Valls Esteve, Eva Huguet Galofré
AIMS: To analyze whether episiotomy affects the urogenital hiatal area and the difference in the hiatus at rest and during contraction, as an indirect measurement of the contractile capacity of the levator ani muscle. METHODS: We performed an observational, comparative, retrospective study of primiparous women who had normal vaginal deliveries. The urogenital hiatal area was compared in women with and without episiotomy. All women underwent transperineal ultrasound scanning after delivery, and all the images were analyzed offline by the principal investigator who was blinded to all clinical data...
June 9, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28594719/bowel-dysfunction-after-low-anterior-resection-with-neoadjuvant-chemoradiotherapy-or-chemotherapy-alone-for-rectal-cancer-a-cross-sectional-study-from-china
#11
Qiyuan Qin, Binjie Huang, Wuteng Cao, Jie Zhou, Tenghui Ma, Zhiyang Zhou, Jianping Wang, Lei Wang
BACKGROUND: Neoadjuvant therapy plays a vital role in the treatment of locally advanced rectal cancer but impairs bowel function after restorative surgery. Optimal decision making requires adequate information of functional outcomes. OBJECTIVE: This study aimed to assess postoperative bowel function and to identify predictors for severe dysfunction. DESIGN: The study included a cross-sectional cohort and retrospective assessments of pelvic anatomic features...
July 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28542276/effect-of-combined-actions-of-hip-adduction-abduction-on-the-force-generation-and-maintenance-of-pelvic-floor-muscles-in-healthy-women
#12
Amanda C Amorim, Licia P Cacciari, Anice C Passaro, Simone R B Silveira, Cesar F Amorim, Jefferson F Loss, Isabel C N Sacco
Pelvic floor muscle (PFM) force and coordination are related to urinary incontinence severity and to sexual satisfaction. Health professionals frequently combine classic PFM exercises with hip adduction/abduction contraction to treat these disorders, but the real benefits of this practice are still unknown. Based on a theoretical anatomy approach whereby the levator ani muscle is inserted into the obturator internus myofascia and in which force generated by hip movements should increase the contraction quality of PFMs, our aim was to investigate the effects of isometric hip adduction and abduction on PFM force generation...
2017: PloS One
https://www.readbyqxmd.com/read/28509338/investigation-of-the-ischioanal-fossa-application-to-abscess-spread
#13
Jian-Fei Zhang, Mei-Ling Du, Hong-Jin Sui, Yong Yang, Huan-Yu Zhou, Chao Meng, Mei-Jing Qu, Qian Zhang, Bin Du, Yuan-Shan Fu
The location of perianal abscesses and the course of the fistula follow certain patterns, especially in the relationship between external and internal openings. However, it is still not clear how the contents of the ischioanal fossa, especially the fibrous network of fat tissue, affect the route for such diseases. Ten male adult cadavers were selected for the study. Seven horizontal transverse section planes from 1 cm above the pubic symphysis to the inferior border of the lesser trochanter of the femur were recorded after P45 sheet plastination...
May 16, 2017: Clinical Anatomy
https://www.readbyqxmd.com/read/28504114/a-shortened-tamoxifen-induction-scheme-to-induce-creer-recombinase-without-side-effects-on-the-male-mouse-skeleton
#14
Ferran Jardí, Michaël R Laurent, Vanessa Dubois, Rougin Khalil, Ludo Deboel, Dieter Schollaert, Ludo Van Den Bosch, Brigitte Decallonne, Geert Carmeliet, Frank Claessens, Dirk Vanderschueren
The selective estrogen receptor modulator tamoxifen exerts estrogen agonistic or antagonistic actions on several tissues, including bone. The off-target effects of tamoxifen are one of the most widely recognized pitfalls of tamoxifen-inducible Cre recombinases (CreERs), potentially confounding the phenotypic findings. Still, the validation of tamoxifen induction schemes that minimize the side effects of the drug has not been addressed. Here, we compared the side effects on the skeleton and other androgen-responsive targets of a shortened tamoxifen regimen (2 doses of 190 mg/kg body weight by oral gavage) to a standard protocol (4 doses) and determined their efficiency in inducing CreER-mediated gene deletion...
May 11, 2017: Molecular and Cellular Endocrinology
https://www.readbyqxmd.com/read/28479768/laparoscopic-sacrocolpopexy-using-barbed-sutures-for-mesh-fixation-and-peritoneal-closure-a-safe-option-to-reduce-operational-times
#15
Panagiotis Kallidonis, Abdulrahman Al-Aown, Marinos Vasilas, Iason Kyriazis, Vasilis Panagopoulos, Fotini Fligou, Anastasios Athanasopoulos, Bagheri Fariborz, Evangelos Liatsikos, Mehmet Özsoy
INTRODUCTION: Laparoscopic sacrocolpopexy (LSC) has established itself as a safe method for the management of pelvic organ prolapse (POP). Laparoscopic suturing is a time-consuming intraoperative task during LSC. Self-retaining barbed sutures (SBSs) are known to reduce the operative time in laparoscopic cases. The current study aimed to evaluate the efficacy and safety of SBS during the performance of LSC. MATERIALS AND METHODS: Twenty female patients with symptomatic POP were treated with LSC by an expert surgeon...
April 2017: Urology Annals
https://www.readbyqxmd.com/read/28462429/on-the-stiffness-of-the-mesh-and-urethral-mobility-a-finite-element-analysis
#16
Sofia Brandão, Marco Parente, Thuane Huyer Da Roza, Elisabete Silva, Isabel Maria Ramos, Teresa Mascarenhas, Renato Manuel Natal Jorge
Midurethral slings are used to correct urethral hypermobility in female stress urinary incontinence, defined as the complaint of involuntary urine leakage when the intra-abdominal pressure is increased. Structural and thermal features influence their mechanical properties, which may explain postoperative complications, e.g., erosion, urethral obstruction. We studied the effect of the mesh stiffness on urethral mobility at Valsalva maneuver, under impairment of the supporting structures (levator ani and/or ligaments), by using a numerical model...
May 2, 2017: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/28455942/the-evaluation-of-pelvic-floor-muscle-strength-in-women-with-pelvic-floor-dysfunction-a-reliability-and-correlation-study
#17
Beatriz Navarro Brazález, María Torres Lacomba, Pedro de la Villa, Beatriz Sánchez Sánchez, Virginia Prieto Gómez, Ángel Asúnsolo Del Barco, Linda McLean
AIMS: The purposes of this study were: (i) to evaluate the reliability of vaginal palpation, vaginal manometry, vaginal dynamometry; and surface (transperineal) electromyography (sEMG), when evaluating pelvic floor muscle (PFM) strength and/or activation; and (ii) to determine the associations among PFM strength measured using these assessments. METHODS: One hundred and fifty women with pelvic floor disorders participated on one occasion, and 20 women returned for the same investigations by two different raters on 3 different days...
April 28, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28450789/body-after-baby-a-pilot-survey-of-genital-body-image-and-sexual-esteem-following-vaginal-birth
#18
Ruth Zielinski, Lisa Kane Low, Abigail R Smith, Janis M Miller
OBJECTIVE: The aim of this study was to determine acceptability of the Vaginal Changes Sexual and Body Esteem (VSBE) scale for women post childbirth and explore the association between childbirth events and sexual/body esteem. DESIGN: This is a cross-sectional study within the Evaluating Maternal Recovery from Labor and Delivery study. SETTING: This study was conducted in a community setting. POPULATION: The study was conducted in women post first vaginal birth with birth events that posed risk factors for levator ani muscle tears...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/28412846/changes-in-levator-hiatus-dimensions-during-pregnancy-and-after-delivery-in-nulliparas-a-prospective-cohort-study-using-3d-transperineal-ultrasound
#19
A Sanozidis, T Mikos, E Assimakopoulos, A Athanasiadis, T Tantanassis, B C Tarlatzis, V Papameletiou
PURPOSE: The purpose of this study was to investigate the changes that occur in the levator ani muscle (1) during pregnancy and (2) after labor depending on the mode of delivery in a cohort of nulliparas. MATERIALS AND METHODS: A prospective cohort longitudinal study, consisting of 84 primiparas who were examined and recruited in an antenatal clinic was conducted. All participants were submitted to a real-time three-dimensional (3D) ultrasonographic evaluation of the levator ani at (1) 12, (2) 22, and (3) 32 weeks of pregnancy (4) and 4-6 months postdelivery...
May 5, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28412085/in%C3%A2-vivo-evidence-of-significant-levator-ani-muscle-stretch-on%C3%A2-mr-images-of-a-live-childbirth
#20
Nikhil Sindhwani, Christian Bamberg, Nele Famaey, Geertje Callewaert, Joachim W Dudenhausen, Ulf Teichgräber, Jan Deprest
OBJECTIVE: Vaginal childbirth is believed to be a significant risk factor for the development of pelvic floor dysfunction later in life. Previous studies have explored the use of medical imaging and simulations of childbirth to determine the stretch in the levator ani muscle. A report in 2012 has recorded magnetic resonance images of a live childbirth of a 24 year old woman giving birth vaginally for the second time, using a 1.0 Tesla open, high-field scanner. Our objective was to determine the stretch ratios in the levator muscle using these magnetic resonance images of live childbirth...
April 13, 2017: American Journal of Obstetrics and Gynecology
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