New-onset rectoanal intussusception may not result in symptomatic improvement after laparoscopic ventral rectopexy for external rectal prolapse

Conclusions Evacuation proctography showed new-onset RAI in some patients with ERP who underwent LVR, which was associated with a lack of symptomatic improvement.
Source: Techniques in Coloproctology - Category: Surgery Source Type: research

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CONCLUSIONS: The STARR technique performed with a single stapler CPH34HV is safe, faster and less expensive than the STARR performed by a double PPH01. Besidas, with the parachute technique, it is possible to resect asymmetric prolapses. PMID: 30620165 [PubMed - as supplied by publisher]
Source: Minerva Chirurgica - Category: Surgery Tags: Minerva Chir Source Type: research
AbstractMR defecography (MRD) is an alternative to conventional defecography (CD) which allows for dynamic visualisation of the pelvic floor. The aim of this study was to assess whether MRI features indicative of pelvic floor dysfunction correlated with patient-reported symptom severity. MR proctograms were matched to a prospectively-maintained functional database. Univariate and multivariate analyses were performed using pre-treatment questionnaire responses to the Birmingham Bowel, Bladder and Urinary Symptom Questionnaire (BBUSQ), Wexner Incontinence Score (WIS), and modified Obstructed Defecation Symptom (ODS) Score. 3...
Source: Updates in Surgery - Category: Surgery Source Type: research
AbstractBackgroundIn recent years, stapled transanal resection (STARR) has been adopted worldwide with convincing short-term results. However, due to the high recurrence rate and some major complications after STARR, there is still controversy about when the procedure is indicated. The aim of this study was to assess the safety, efficacy and feasibility of STARR performed with a new dedicated device for tailored transanal stapled surgery.MethodsAll the consecutive patients affected by obstructed defecation syndrome (ODS) due to rectocele or/and rectal intussusception, who underwent STARR with the TST STARR-Plus stapler, we...
Source: Techniques in Coloproctology - Category: Surgery Source Type: research
AbstractPurpose of ReviewDefecatory dysfunction is infrequently considered a gynaecological problem. However, obstructed defecation (OD) more commonly affects women than men and is associated with pelvic floor dysfunction. Therefore, we set out to write a review from a urogynaecologists ’ prospective focusing on OD as it relates to the pelvic floor.Recent FindingsLiterature on this topic remains sparse and the studies tend to have a low sample size. It is clear that OD is associated with pelvic floor dysfunction including urinary incontinence and structural dysfunction; however, it is less clear which is the primary ...
Source: Current Obstetrics and Gynecology Reports - Category: OBGYN Source Type: research
ConclusionsThese data show that proctographic findings can help predict functional outcomes after LVMR. Presence of an enterocele and a vertical axis of the rectum at rest may be associated with a better resolution of symptoms.
Source: Techniques in Coloproctology - Category: Surgery Source Type: research
Clinics in Colon and Rectal Surgery 2017; 30: 005-011 DOI: 10.1055/s-0036-1593433Rectoanal intussusception is an invagination of the rectal wall into the lumen of the rectum. Patients may present with constipation, incomplete evacuation, incontinence, or may be asymptomatic. Defecography has been the gold standard for detection. Magnetic resonance imaging defecography and dynamic anal endosonography are alternatives to conventional defecography. However, both methods are not as sensitive as conventional defecography. Treatment options range from conservative/medical treatment such as biofeedback to surgical procedures such...
Source: Clinics in Colon and Rectal Surgery - Category: Surgery Authors: Tags: Review Article Source Type: research
Conclusions &InferencesIn this study, 3DHRAM was used to diagnose RI, and we confirmed its use in the diagnosis of pelvic floor disorders. Further studies will be necessary to define classifications for these new anatomic data from 3DHRAM. Three‐dimensional high‐resolution anorectal manometry (3DHRAM) provides physiological and morphological data about the perineum. The aim of this study was to define a diagnostic strategy using 3DHRAM to identify rectal intussusceptions (RI). On 3DHRAM, an anterior additional high‐pressure area associated with an excessive perineal descent allowed the diagnosis of RI with a pos...
Source: Neurogastroenterology and Motility - Category: Gastroenterology Authors: Tags: Original Article Source Type: research
CONCLUSIONS: Three-dimensional endovaginal ultrasonography is a reliable technique for assessment of perineal descent. Using this technique, excessive perineal descent can be defined as displacement of the anorectal junction>1 cm and/or its position below the symphysis pubis on Valsalva maneuver.
Source: Diseases of the Colon and Rectum - Category: Gastroenterology Tags: Original Contributions: Pelvic Floor Source Type: research
ConclusionRectal prolapse traumatizes the rectum causing neuromuscular defects. The tissue trauma is due to shearing forces and ischemia caused by the intussusception. This initiates a self-reinforcing vicious circle of physical and functional obstruction, further impairing rectal evacuation and causing constipation and incontinence. The correlation between extent of prolapse and age suggests that internal rectal prolapse can be considered a degenerative disorder. Neural and motor defects in the wall of the rectum caused by rectal prolapse are likely irreversible.
Source: International Journal of Colorectal Disease - Category: Gastroenterology Source Type: research
This study was approved by the local human research ethics committee (Nepean Blue Mountains Local Health District Human Research Ethics Committee, IRB approval no. 13–16). Results The datasets of 719 women were analyzed. Mean age was 56.1 (18.4–87.6) years. Ninety-seven patients (13 %) reported fecal incontinence, 190 (26 %) constipation, and 461 (64 %) symptoms of OD. On examination, 405 women (56 %) were diagnosed with significant posterior compartment prolapse (POP-Q ≥ stage 2), which was associated with symptoms of OD (p 
Source: International Urogynecology Journal - Category: OBGYN Source Type: research
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