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Levator ani syndrome

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
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
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
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
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
Jenny Kurz, Diane Borello-France
Background and Purpose: Women with postpartum pelvic organ prolapse (POP) and urinary incontinence are often treated by physical therapists specializing in women's health. Movement system impairments often coexist in this patient population. The purpose of this case report is to describe the physical therapist treatment of a woman with postpartum POP complicated by additional pelvic symptoms. Case Description: A 31-year-old woman presented with postpartum POP, diastasis recti, urinary incontinence, and constipation...
April 1, 2017: Physical Therapy
Satish Sc Rao, Adil E Bharucha, Giuseppe Chiarioni, Richelle Felt-Bersma, Charles Knowles, Allison Malcolm, Arnold Wald
This report defines criteria and reviews the epidemiology, pathophysiology, and management of common anorectal disorders: fecal incontinence (FI), functional anorectal pain and functional defecation disorders. FI is defined as the recurrent uncontrolled passage of fecal material for at least 3 months. The clinical features of FI are useful for guiding diagnostic testing and therapy. Anorectal manometry and imaging are useful for evaluating anal and pelvic floor structure and function. Education, antidiarrheals and biofeedback therapy are the mainstay of management; surgery may be useful in refractory cases...
March 25, 2016: Gastroenterology
Sara Bibi, Massarat Zutshi, Brooke Gurland, Tracy Hull
PURPOSE: The aim of this study was to evaluate the efficacy of Botulinum toxin-A (Botox) in relieving anal pain associated with anal fissure (AF) and Levator ani syndrome (LS). METHODS: All patients with medically refractory AF or LS from 2005 to 2012 and treated with Botox injections were included. RESULTS: One hundred and three patients [66 patients (53 female) with AF and 37 patients (26 female) with LS] were evaluated. The minimum/maximum dose of Botox was 20/100 units for AF and 50/200 units for LS...
January 2016: Postgraduate Medicine
A Lenore Ackerman, Una J Lee, Forrest C Jellison, Nelly Tan, Maitraya Patel, Steven S Raman, Larissa V Rodriguez
INTRODUCTION AND HYPOTHESIS: In interstitial cystitis/bladder pain syndrome (IC/BPS), pelvic floor dysfunction may contribute significantly to pelvic pain. To determine if pelvic floor hypertonicity manifests alterations on magnetic resonance imaging (MRI) in patients with IC/BPS, we retrospectively compared pelvic measurements between patients and controls. METHODS: Fifteen women with IC/BPS and 15 age-matched controls underwent pelvic MRI. Two blinded radiologists measured the pelvic musculature, including the H- and M lines, vaginal length, urethral length and cross-sectional area, levator width and length, and posterior puborectalis angle...
January 2016: International Urogynecology Journal
Mohsen Bahmani Kashkouli, Sahab Shahrzad, Anis Alsadat Jazayeri, Mohammad Bagher Abtahi
Schwartz-Jampel syndrome is an autosomal recessive disease that comprises facial and musculoskeletal deformity. Hereby, the authors report 2 cases of Schwartz-Jampel syndrome and surgical method of their management. The first case was a boy who was result of twin delivery whose sibling was completely normal. The second case was a girl who was the first child of her family. Both were born to a consanguineous marriage. Both had developed characteristic facial expressions of Schwartz-Jampel syndrome between 18 and 24 months of age...
May 2017: Ophthalmic Plastic and Reconstructive Surgery
S S C Rao, M A Benninga, A E Bharucha, G Chiarioni, C Di Lorenzo, W E Whitehead
BACKGROUND: Anorectal disorders such as dyssynergic defecation, fecal incontinence, levator ani syndrome, and solitary rectal ulcer syndrome are common, and affect both the adult and pediatric populations. Although they are treated with several treatment approaches, over the last two decades, biofeedback therapy using visual and verbal feedback techniques has emerged as an useful option. Because it is safe, it is commonly recommended. However, the clinical efficacy of biofeedback therapy in adults and children is not clearly known, and there is a lack of critical appraisal of the techniques used and the outcomes of biofeedback therapy for these disorders...
May 2015: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Aranzazu Calero-Lillo, Enric Caubet
INTRODUCTION: Ischiorrectal tumoral masses mimicking perianal abscess and abscess from uncommon microbiological origins have previously been reported. PRESENTATION OF CASE: Unusual perianal abscess arising from an hematoma in an elderly woman with myelodysplastic syndrome: the patient presented on the emergency with gluteal pain and fever after intramuscular injection of analgesic drug. Physical examination revealed subcutaneous thickening on gluteus and perianal region, without skin changes...
2014: International Journal of Surgery Case Reports
A Graziottin, P P Zanello, G D'Errico
Recurrent vaginitis and cystitis are a daily challenge for the woman and the physician. The recurrence worsens the symptoms' severity, increases comorbidities, both pelvic (provoked vestibulodynia, bladder pain syndrome, levator ani hyperactivity, introital dyspareunia, obstructive constipation, chronic pelvic pain) and cerebral (neuroinflammation and depression), increases health costs, worsens the quality of life. Antibiotics increase the risk of bacterial resistences and devastate the ecosystems: intestinal, vaginal and mucocutaneous...
October 2014: Minerva Ginecologica
Chen-yi Xu, Shu-qing Ding, Ya-hong Xue, Yi-jiang Ding, Da-chao Xu
OBJECTIVE: To explore the value of dynamic three-dimensional ultrasound in detecting the levator ani muscle fissures morphological changes of female pelvic floor relaxation syndrome after biofeedback and acupuncture treatments. METHODS: Forty female constipation patients with pelvic floor relaxation syndrome were screened from the Constipation Designed Disease Clinic in our hospital between October 2011 and September 2012. Cleveland Constipation Score (CCS) scale was used...
December 2013: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Markus Huebner, Katharina Rall, Sara Yvonne Brucker, Christl Reisenauer, Katja Claudia Siegmann-Luz, John O L DeLancey
INTRODUCTION AND HYPOTHESIS: Ongoing debate exists about whether the rectovaginal septum (Denonvilliers' fascia) is myth or reality. This study evaluates magnetic resonance images (MRI) of women with Müllerian agenesis for the presence of fascial layers between the rectum and the bladder to test the hypothesis that this layer exists in the absence of the vagina. METHODS: This is a secondary analysis of a study describing MRI aspects in women with vaginal agenesis before and after laparoscopic Vecchietti procedure...
March 2014: International Urogynecology Journal
Olivier Pittet, Nicolas Demartines, Dieter Hahnloser
Acute anal pain is a common proctological problem. A detailed history together with the clinical examination are crucial for the diagnosis. An acute perianal vein thrombosis can be successfully excised within the first 72 hours. Acute anal fissures are best treated conservatively using stool regulation and topical medications reducing the sphincter spasm. A chronic anal fissure needs surgery. Perianal abscesses can very often be incised and drained in local anesthesia. Proctalgia fugax and the levator ani syndrome are exclusion diagnoses and are treated symptomatically...
July 2013: Therapeutische Umschau. Revue Thérapeutique
Xiao-Bing Sun, Dian-Guo Li, Xiao-Gang Sun, Qian Liu, Jin-Liang Li
OBJECTIVE: To study the development of pelvic floor muscle, morphology and location of rectum and anal canal as well as morphology of spinal cord and sacrum based on pelvic magnetic resonance imaging(MRI) of children with fecal incontinence after anoplasty for anorectal malformation and to provide information on management of fecal incontinence. METHODS: Clinical and MRI data of 34 children with fecal incontinence after anoplasty for anorectal malformation in the Second Hospital of Shangdong University from September 2009 to December 2011 were analyzed retrospectively...
May 2013: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Roy S Dwarkasing, W Rudolf Schouten, Tychon E A Geeraedts, Litza E Mitalas, Wim C J Hop, Gabriel P Krestin
OBJECTIVE: The purpose of this study was to assess the diagnostic value of anorectal MRI in the care of patients with chronic anal and perianal pain but without findings of abnormalities in the clinical workup. MATERIALS AND METHODS: Patients referred from a tertiary department of colorectal surgery to the MRI unit with clinically occult chronic anal and perianal pain were included. MRI of the anorectum was performed with an endoanal or pelvic phased-array coil...
May 2013: AJR. American Journal of Roentgenology
V Piloni, P Tosi, M Vernelli
BACKGROUND: The aim of this study was to evaluate the use of a magnetic resonance (MR)-based classification system of obstructive defecation syndrome (ODS) to guide physicians in patient management. METHODS: The medical records and imaging series of 105 consecutive patients (90 female, 15 male, aged 21-78 years, mean age 46.1 ± 5.1 years) referred to our center between April 2011 and January 2012 for symptoms of ODS were retrospectively examined. After history taking and a complete clinical examination, patients underwent MR imaging according to a standard protocol using a 0...
October 2013: Techniques in Coloproctology
Maheen Sheikh, Crystal A Kunka, Ken S Ota
OBJECTIVE: To report a case of levator ani syndrome (LAS) that was successfully treated with cyclobenzaprine. CASE SUMMARY: A 26-year-old male presented with a 3-week history of severe, intermittent, aching anorectal pain that would last for 30-60 minutes per episode and occurred between 1 and 3 times per day. The pain was aggravated by squatting, with no alleviating factors. Physical examination revealed no prostate tenderness, lesions, hemorrhoids, or fissures and rectal tone was intact...
October 2012: Annals of Pharmacotherapy
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