Drainage Seton Versus External Anal Sphincter–Sparing Seton After Rerouting of the Fistula Tract in the Treatment of Complex Anal Fistula: A Randomized Controlled Trial

BACKGROUND: Complex anal fistula is one of the challenging anorectal conditions. Several treatments have been proposed for complex anal fistula, yet none proved to be ideal. OBJECTIVE: This randomized trial aimed to assess the efficacy of external anal sphincter–sparing seton in comparison with the conventional drainage seton in the treatment of complex anal fistula. DESIGN: This was a prospective, randomized, single-blind controlled study. SETTINGS: The study was conducted at the Colorectal Surgery Unit of Mansoura University Hospitals. PATIENTS: Adult patients of both sexes with complex anal fistula were recruited and evaluated with MRI before surgery. INTERVENTIONS: Patients were randomly divided into 2 groups; group 1 was treated with conventional drainage seton and group 2 was treated with external anal sphincter–sparing seton using a rerouting technique. MAIN OUTCOME MEASURES: The duration of healing, incidence of recurrence or persistence, postoperative pain, and complications including fecal incontinence were measured. RESULTS: Sixty patients (56 men) with a mean age of 43 years were included. Mean operation time in group 1 was significantly shorter than group 2 (29.8 ± 4.3 vs 43.8 ± 4.5 min; p
Source: Diseases of the Colon and Rectum - Category: Gastroenterology Tags: Original Contributions: Anorectal Source Type: research

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ConclusionResults showed that, choosing a delivery method is difficult for primiparous women, and their attitude toward the type of delivery is influenced by subjective and internal factors. Giving awareness to primiparous women greatly enhances their tendency towards vaginal delivery.
Source: Archives of Public Health - Category: International Medicine & Public Health Source Type: research
We present our findings in the form of evidence maps.ResultsWe included 16 good-quality systematic reviews examining biofeedback alone or as an adjunctive intervention. We found clear, consistent evidence across a large number of trials that biofeedback can reduce headache pain and can provide benefit as adjunctive therapy to men experiencing urinary incontinence after a prostatectomy. Consistent evidence across fewer trials suggests biofeedback may improve fecal incontinence and stroke recovery. There is insufficient evidence to draw conclusions about effects for most conditions including bruxism, labor pain, and Raynaud ...
Source: Journal of General Internal Medicine - Category: Internal Medicine Source Type: research
ConclusionTVT-Abbrevo has similar efficacy and safety compared with TVT-O in women with SUI; the use of a shorter sling reduces postoperative pain.
Source: International Urogynecology Journal - Category: OBGYN Source Type: research
ConclusionsIn conclusion, we believe this procedure has good results in short term follow up (3 months after surgery), but a high recurrence rate in the middle term follow up. Therefore, this procedure is no longer recommended.ResumoIntroduçãoA taxa de recorrência do prolapso de órgãos pélvicos é uma questão importante que afeta a qualidade de vida do paciente, resultando em um novo procedimento cirúrgico. Os autores adotaram uma nova técnica de suspensão laparoscópica de órgãos pélvicos (suspensão retal) no trata...
Source: Journal of Coloproctology - Category: Gastroenterology Source Type: research
CONCLUSION: The VIRTUE © sling seems to be an effective, safe tool treating SUI at short term. LEVEL OF EVIDENCE: 3. PMID: 31387835 [PubMed - as supplied by publisher]
Source: Progres en Urologie - Category: Urology & Nephrology Tags: Prog Urol Source Type: research
ConclusionThe thorough selection of the patients, the detailed surgical gestures, the bladder emptying without instrumentation of the urethra, together with a correct use of analgesics and early ambulation allowed excellent outcomes obtained in these patients managed with a short hospital stay and without bladder drainage, also demonstrating the safety of the procedure at 5 years of follow-up.ResumenObjetivoDescribir nuestra experiencia a largo plazo de pacientes portadores de reflujo vesicoureteral (RVU) operados a cielo abierto sin drenaje vesical postoperatorio.Material y métodoRevisión retrospectiva de 45...
Source: Actas Urologicas Espanolas - Category: Urology & Nephrology Source Type: research
AbstractIntroduction and hypothesisOur aim was to investigate the efficacy of the EndoFast Reliant ™ system, which is a novel trocarless mesh technology for the treatment of pelvic organ prolapse (POP).MethodsThis was a retrospective cohort study including 31 female patients with POP who underwent vaginal repair. Total follow-up duration was 24  months. All patients were evaluated with a clinical history, POP-Q measures, pelvic ultrasound, body mass index (BMI), questionnaires on symptoms, and quality of life scoring system.ResultsThe mean age was 53  ± 9.7 years, and the mean BMI was 2...
Source: International Urogynecology Journal - Category: OBGYN Source Type: research
AbstractTransverse myelitis is a segmental, full-thickness inflammation of the spinal cord with various etiologies including varicella zoster virus infection. Symptoms can manifest as sensory deficits, severe lower back pain radiating down the legs, bowel/bladder incontinence, and extremity weakness. This case report is unique in that it highlights a patient who developed long-segment transverse myelitis after a varicella zoster virus infection which has not been previously reported in the literature.
Source: Journal of NeuroVirology - Category: Neurology Source Type: research
Abstract Individuals with intellectual disability can experience multifaceted physical, psychological, emotional health and wellbeing problems. Chronic constipation is one of the major health problems for this cohort of the population; it is linked with distress, discomfort, pain, faecal incontinence, anxiety, behavioural difficulties and severe gastrointestinal complications. A continence assessment process for constipation ensures that planning, implementation and evaluation strategies provide quality health outcomes for individuals and their families. Proactive treatment interventions range from increasing flui...
Source: British Journal of Community Nursing - Category: Nursing Authors: Tags: Br J Community Nurs Source Type: research
We report the multicentre comparison of the different port types of the adjustable transobturator male incontinence system (ATOMS, A.M.I., Austria).MethodsBetween 10/09 and 10/16, 383 patients received an ATOMS. Of these, 63% received the inguinal port (IP, 2009 –2013), 23% the intraoperative manually connectable scrotal port (SP, 2013–2015), and 14% the pre-connected fully silicone-covered scrotal port (SSP, 2014–2016). During the follow-up period, continence parameters, pain and quality of life ratings and postoperative port-associated complications were evaluated and compared. Statistical analysis was ...
Source: World Journal of Urology - Category: Urology & Nephrology Source Type: research
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