1
|
Markaryan DR, Tsarkov PV, Tulina IA, Kitsenko YE, Garmanova TN, Roche B. Modern technique for sphincter repair after obstetric perineal trauma - a video vignette. Colorectal Dis 2020; 22:1456-1457. [PMID: 32323905 DOI: 10.1111/codi.15079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 03/28/2020] [Indexed: 02/08/2023]
Affiliation(s)
- D R Markaryan
- I. M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.,Geneva University Hospitals and Medical School, Geneva, Switzerland
| | - P V Tsarkov
- I. M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.,Geneva University Hospitals and Medical School, Geneva, Switzerland
| | - I A Tulina
- I. M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.,Geneva University Hospitals and Medical School, Geneva, Switzerland
| | - Y E Kitsenko
- I. M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.,Geneva University Hospitals and Medical School, Geneva, Switzerland
| | - T N Garmanova
- I. M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.,Geneva University Hospitals and Medical School, Geneva, Switzerland
| | - B Roche
- I. M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.,Geneva University Hospitals and Medical School, Geneva, Switzerland
| |
Collapse
|
2
|
Brusciano L, Gambardella C, Roche B, Tolone S, Romano RM, Tuccillo F, Del Genio G, Terracciano G, Gualtieri G, Docimo L. Dynamic transperineal ultrasonography correlates with prolonged pudendal nerve latency in female with fecal incontinence. Updates Surg 2020; 72:1187-1194. [PMID: 32596803 DOI: 10.1007/s13304-020-00838-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 06/21/2020] [Indexed: 12/17/2022]
Abstract
The pelvic floor is a complex anatomical entity and its neuromuscular assessment is evaluated through debated neurophysiological tests. An innovative approach is the study of pelvic floor through dynamic transperineal ultrasound (DTU). The aim of this study is to evaluate DTU sensitivity in recognizing patients with fecal incontinence and to evaluate its concordance with the results of the motor latency studied via pudendal nerve terminal motor latency (PNTML). Female patients affected by FI addressed to our center of coloproctology were prospectively assessed. After a coloproctological evaluation, comprising the PNTML assessment to identify pudendal neuropathy, patients were addressed to DTU to determine anterior and posterior displacement of puborectalis muscle by a blinded coloproctologist. In order to compare the data, a cohort of female healthy volunteers was enrolled. Sixty-eight subjects (34 patients and 34 healthy volunteers) were enrolled. The sensitivities of anterior displacement, posterior displacement and either anterior or posterior displacement in determining the fecal incontinence were 82%, 67% and 91%, respectively. A further high correlation of either anterior or posterior displacement with PTNML was also noted (88%). DTU is an indirect, painless and reproducible method for the identification of the pelvic floor neuromuscular integrity. Its findings seem to highly correlate with FI symptoms and with PNTML results. In the near future, after larger comparative studies, DTU would be considered a potential reliable non-invasive and feasible indirect procedure in the identification of fecal incontinence by pudendal neuropathy. Trial registration number is NCT03933683.
Collapse
Affiliation(s)
- Luigi Brusciano
- Division of General, Mini-Invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli" Naples, via Luigi Pansini n° 5, 80131, Naples, Italy
| | - Claudio Gambardella
- Division of General, Mini-Invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli" Naples, via Luigi Pansini n° 5, 80131, Naples, Italy. .,Department of Cardiothoracic Sciences, School of Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.
| | - Bruno Roche
- Proctology Unit, Division of Visceral Surgery, Department of Surgery, Geneva University Hospitals and Medical School, 4 Rue Gabrielle-Perret-Gentil, Geneva 14, 1211, Geneva, Switzerland
| | - Salvatore Tolone
- Division of General, Mini-Invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli" Naples, via Luigi Pansini n° 5, 80131, Naples, Italy
| | - Roberto Maria Romano
- Division of General, Mini-Invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli" Naples, via Luigi Pansini n° 5, 80131, Naples, Italy
| | - Francesco Tuccillo
- Division of General, Mini-Invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli" Naples, via Luigi Pansini n° 5, 80131, Naples, Italy
| | - Gianmattia Del Genio
- Division of General, Mini-Invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli" Naples, via Luigi Pansini n° 5, 80131, Naples, Italy
| | - Gianmattia Terracciano
- Division of General, Mini-Invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli" Naples, via Luigi Pansini n° 5, 80131, Naples, Italy
| | - Giorgia Gualtieri
- Division of General, Mini-Invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli" Naples, via Luigi Pansini n° 5, 80131, Naples, Italy
| | - Ludovico Docimo
- Division of General, Mini-Invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli" Naples, via Luigi Pansini n° 5, 80131, Naples, Italy
| |
Collapse
|
3
|
Abstract
Anorectal incontinence is a symptom of a complex multifactorial disorder involving the pelvic floor and anorectum, which is a severe disability and a major social problem. Various causes may affect the anatomical and functional integrity of the pelvic floor and anorectum, leading to the anorectal continence disorder and incontinence. The most common cause of anorectal incontinence is injury of the sphincter muscles following delivery or anorectal surgeries. Although the exact incidence of anorectal incontinence is unknown, various studies suggest that it affects ~2.2-8.3% of adults, with a significant prevalence in the elderly (>50%). The successful treatment of anorectal incontinence depends on the accurate diagnosis of its cause. This can be achieved by a thorough assessment of patients. The management of incontinent patients involves conservative therapeutic procedures, surgical techniques, and minimally invasive approaches.
Collapse
|
4
|
Kołodziejczak M, Santoro GA, Słapa RZ, Szopiński T, Sudoł-Szopińska I. Usefulness of 3D transperineal ultrasound in severe stenosis of the anal canal: preliminary experience in four cases. Tech Coloproctol 2013; 18:495-501. [PMID: 24081548 PMCID: PMC3996354 DOI: 10.1007/s10151-013-1078-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2013] [Accepted: 09/17/2013] [Indexed: 12/25/2022]
Abstract
Background Organic or functional anal canal stenoses are uncommon conditions that occur in the majority of cases as a consequence of anal diseases. A proper assessment is fundamental for decision making; however, proctological examination and endoanal ultrasound are often unfeasible or very difficult to perform even under local or general anesthesia. We therefore began to use 3D transperineal ultrasound to assess patients. The aim of this study was to compare the results of evacuation proctography and 3D transperineal ultrasound in patients with severe anal canal stenosis. Methods Four consecutive patients with high-grade anal canal stenosis were evaluated using both proctography and 3D transperineal ultrasound with a micro-convex transducer between March and June 2011. Results In all cases, 3D transperineal ultrasound provided detailed information on the length and level of stenosis and on the integrity of the anal sphincters. Conclusions Our preliminary experience suggests that 3D transperineal ultrasound makes it possible to plan optimal surgical treatment.
Collapse
Affiliation(s)
- M Kołodziejczak
- Department of Proctology, Hospital at Solec, 00-382, Warsaw, Poland
| | | | | | | | | |
Collapse
|