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Levator ani

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https://www.readbyqxmd.com/read/28154915/prolapse-symptoms-are-associated-with-abnormal-functional-anatomy-of-the-pelvic-floor
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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