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Levator ani

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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
#1
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
#2
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...
January 6, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28042624/literature-review-of-factors-affecting-continence-after-radical-prostatectomy
#3
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
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/27886590/pelvic-floor-dynamics-during-high-impact-athletic-activities-a-computational-modeling-study
#7
Nicholas Dias, Yun Peng, Rose Khavari, Nissrine A Nakib, Robert M Sweet, Gerald W Timm, Arthur G Erdman, Timothy B Boone, Yingchun Zhang
BACKGROUND: Stress urinary incontinence is a significant problem in young female athletes, but the pathophysiology remains unclear because of the limited knowledge of the pelvic floor support function and limited capability of currently available assessment tools. The aim of our study is to develop an advanced computer modeling tool to better understand the dynamics of the internal pelvic floor during highly transient athletic activities. METHODS: Apelvic model was developed based on high-resolution MRI scans of a healthy nulliparous young female...
November 18, 2016: Clinical Biomechanics
https://www.readbyqxmd.com/read/27872979/evaluation-of-isolated-urinary-stress-incontinence-according-to-the-type-of-levator-ani-muscle-lesion-using-3-4d-transperineal-ultrasound-36%C3%A2-months-post-partum
#8
José Antonio García Mejido, Pamela Valdivieso Mejias, Ana Fernández Palacín, María José Bonomi Barby, Paloma De la Fuente Vaquero, José Antonio Sainz Bueno
INTRODUCTION: Vaginal delivery can lead to pelvic floor disorders. Many authors have described pelvic floor injuries that can predict future defects such as urinary incontinence and pelvic organ prolapse. We propose the assessment of urinary stress incontinence and its association with levator ani muscle (LAM) microtrauma (>20% in the levator hiatus area during Valsalva) and macrotraumas (avulsion) identified by 3/4D transperineal ultrasound (3D-TpUS) 36 months post-partum. MATERIALS AND METHODS: This was a prospective observational study including 168 nulliparous women...
November 21, 2016: International Urogynecology Journal
https://www.readbyqxmd.com/read/27868224/evaluation-of-levator-ani-muscle-throughout-the-different-stages-of-labor-by-transperineal-3d-ultrasound
#9
José Antonio García Mejido, Carmen M Suárez Serrano, Ana Fernández Palacín, Adriana Aquise Pino, María José Bonomi Barby, José Antonio Sainz Bueno
OBJECTIVE: Description and assessment by 3-D transperineal ultrasound of modifications suffered by pelvic floor muscles during the passage of the fetal head through the birth canal during the second stage of labor, as well as the identification of the precise moment in which levator ani muscle avulsion takes place. MATERIALS AND METHODS: Patients included were 35 primigravidae, recruited during the first stage of labor, with at term pregnancy (37-42 weeks), without serious maternal-fetal pathology and cephalic presentation...
November 21, 2016: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/27824643/clinical-psychological-and-physiological-correlates-of-patients-who-defecate-after-meal
#10
Michel Bouchoucha, Ghislain Devroede, Florence Mary, Cyriaque Bon, Gheorges Airinei, Bakhtiar Bejou, Robert Benamouzig
BACKGROUND AND AIMS: Food is the most important synchronizer of gastrointestinal motility and secretion. Many patients with functional bowel or anorectal disorders complain of fecal urge and stool output after eating. PATIENTS AND METHODS: In this prospective observational study, 408 consecutive outpatients with functional bowel and/or anorectal disorders (74% female, 50.2±15.6 years, 24.8±5.0 kg/m²) filled Rome III questionnaires. Depression and anxiety scores, a physiological evaluation (total and segmental colonic transit time, colonic transit response to eating using a standard 1000 kcal test meal, and anorectal manometry), were measured...
February 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27813139/levator-ani-muscle-innervation-anatomical-study-in-human-fetus
#11
Krystel Nyangoh Timoh, Thomas Bessede, Cedric Lebacle, Mazen Zaitouna, Jelena Martinovic, Djibril Diallo, Maud Creze, Jean-Marc Chevallier, Emile Darai, Gérard Benoît, David Moszkowicz
AIMS: To characterize the nature and function of the levator ani muscle innervation pathways and to perform a comprehensive three-dimensional reconstruction of female pelvic innervation. METHODS: A computer-assisted anatomical dissection protocol was applied to seven female human fetuses, after approval from the national biomedicine agency. Specimens were serially sectioned and immunostained for overall (antibody against protein S100), somatic (antibody against peripheral myelin protein 22), adrenergic (antibody against tyrosine hydroxylase), cholinergic (antibody against vesicular acetylcholine transferase), and nitrergic (antibody against the neural isoform of nitric oxide synthase) nerve fibers...
November 4, 2016: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/27781241/-laparoscopic-total-mesorectum-excision-with-the-guidance-of-membrane-anatomy
#12
Pan Chi
The efficacy of laparoscopic total mesorectum excision (TME) has been confirmed by many clinical trials and guidelines. But two issues on laparoscopic TME are still questioned, including the integrity of specimen membrane of TME and the incidence of postoperative sexual dysfunction. According to my experiences and the primary results of the multicenter clinical trial (LASRE, clinicaltrials.gov identifier: NCT01899547) conducted by me, the integrity of the specimen membrane of laparoscopic TME is not inferior to the open TME...
October 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/27778369/is-bladder-neck-and-urethral-mobility-associated-with-urinary-incontinence-and-mode-of-delivery-4-years-after-childbirth
#13
Ingrid Volløyhaug, Isabelle van Gruting, Kim van Delft, Abdul H Sultan, Ranee Thakar
AIMS: To study changes in bladder neck, urethral mobility and urinary incontinence (UI) from pregnancy to 4 years postpartum and demonstrate any association to mode of delivery or presence of levator ani muscle (LAM) injury. Secondly, we aimed to correlate bladder neck and urethral mobility to UI symptoms. METHODS: Prospective study of 180 women, recruited in their first pregnancy and followed up 1 and/or 4 years postpartum. UI symptoms were assessed with a validated questionnaire...
October 24, 2016: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/27751429/repair-of-old-perineal-laceration-accompanied-by-rectovaginal-fistula-using-levator-ani-muscle-interposition
#14
Shintaro Makino, Jun Takeda, Satoru Takeda
No abstract text is available yet for this article.
October 2016: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27733887/sciatica-an-extremely-rare-complication-of-the-perianal-abscess
#15
Rahul Gujrathi, Kanchan Gupta, Chetan Ravi, Bhujang Pai
BACKGROUND: Sciatica has been classically described as pain in the back and hip with radiation in the leg along the distribution of the sciatic nerve, secondary to compression or irritation of the sciatic nerve. Spinal abnormality being the most common etiology, is one of the most common indications for MRI of the lumbosacral spine. Here we describe imaging findings secondary to a supralevator perianal abscess causing irritation of the sciatic nerve, which was diagnosed on MRI of the lumbosacral spine...
2016: Polish Journal of Radiology
https://www.readbyqxmd.com/read/27718502/pelvic-floor-muscle-dysfunction-at-3d-4d-transperineal-ultrasound-in-patients-with-deep-infiltrating-endometriosis-a-pilot-study
#16
Diego Raimondo, Aly Youssef, Mohamed Mabrouk, Simona Del Forno, Valentina Martelli, Gianluigi Pilu, Nicola Rizzo, Letizia Zannoni, Roberto Paradisi, Renato Seracchioli
OBJECTIVE: Pelvic floor muscle (PFM) dysfunction seems to play an important role in the pathophysiology of pain in women with with pelvic pain syndromes, including deep infiltrating endometriosis (DIE). The aim of the study was to evaluate static and dynamic morphometry of PFM in women affected by DIE, in comparison to asymptomatic control women, using three-dimensional (3D) and four-dimensional (4D) transperineal ultrasound. METHODS: A pilot, prospective study was conducted between March 2015 and November 2015, at our tertiary center...
October 8, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27712641/anorectal-and-pelvic-pain
#17
REVIEW
Adil E Bharucha, Tae Hee Lee
Although pelvic pain is a symptom of several structural anorectal and pelvic disorders (eg, anal fissure, endometriosis, and pelvic inflammatory disease), this comprehensive review will focus on the 3 most common nonstructural, or functional, disorders associated with pelvic pain: functional anorectal pain (ie, levator ani syndrome, unspecified anorectal pain, and proctalgia fugax), interstitial cystitis/bladder pain syndrome, and chronic prostatitis/chronic pelvic pain syndrome. The first 2 conditions occur in both sexes, while the latter occurs only in men...
October 2016: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/27704154/age-related-alterations-in-female-obturator-internus-muscle
#18
Mark S Cook, Laura Bou-Malham, Mary C Esparza, Marianna Alperin
INTRODUCTION AND HYPOTHESIS: Pelvic floor muscle rehabilitation is a widely utilized, but often challenging therapy for pelvic floor disorders, which are prevalent in older women. Regimens involving the use of appendicular muscles, such as the obturator internus (OI), have been developed for strengthening of the levator ani muscle (LAM). However, changes that lead to potential dysfunction of these alternative targets in older women are not well known. We hypothesized that aging negatively impacts OI architecture, the main determinant of muscle function, and intramuscular extracellular matrix (ECM), paralleling age-related alterations in LAM...
October 4, 2016: International Urogynecology Journal
https://www.readbyqxmd.com/read/27672795/poster-27-acupuncture-treatment-for-levator-ani-syndrome-a%C3%A2-case-report
#19
Hamad T Saleemi, Henna Farooque, Sunia Choudhury, Jun Zhang
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/27672474/levator-ani-necrosis-an-exceptional-complication-occurring-after-high-intensity-focused-ultrasound-of-the-prostate
#20
Danny Badawy, Elie El Rassy, Fouad Aoun, Roland Van Velthoven
High intensity focused ultrasound (HIFU) is a minimally invasive treatment option that might be considered in the management of localized prostate cancer. It is a well-tolerated treatment with few minor urologic complications and no major toxicities. In this paper, we report to our knowledge the first case of levator ani necrosis in a patient treated with HIFU, manifesting as sturdy perineal pain, which took years of NSAID intake and serial MRIs to demonstrate partial improvement. Therefore, we regard HIFU as a serious potential treatment option that still requires longer follow-up data before its approval in the personalized treatment panel of prostate cancer...
2016: Case Reports in Urology
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