Types of pelvic floor dysfunctions in nulliparous, vaginal delivery, and cesarean section female patients with obstructed defecation syndrome identified by echodefecography

2009 ◽  
Vol 24 (10) ◽  
pp. 1227-1232 ◽  
Author(s):  
Sthela M. Murad-Regadas ◽  
Francisco Sérgio P. Regadas ◽  
Lusmar V. Rodrigues ◽  
Leticia Oliveira ◽  
Rosilma G. L. Barreto ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Pelvic Floor ◽  
Vaginal Delivery ◽  
Obstructed Defecation ◽  
Obstructed Defecation Syndrome ◽  
Female Patients

scholarly journals Influence of age, mode of delivery and parity on the prevalence of posterior pelvic floor dysfunctions

2011 ◽  
Vol 48 (4) ◽  
pp. 265-269 ◽  
Author(s):  
Sthela Maria Murad-Regadas ◽  
Francisco Sergio P Regadas ◽  
Lusmar Veras Rodrigues ◽  
Débora Couto Furtado ◽  
Ana Cecília Gondim ◽  
...  
Keyword(s):  
Pelvic Floor ◽  
Vaginal Delivery ◽  
Mode Of Delivery ◽  
Obstructed Defecation ◽  
Delivery Mode ◽  
Obstructed Defecation Syndrome ◽  
Group I ◽  
Vaginal Deliveries ◽  
Grade Ii ◽  
Group Ii

CONTEXT: The correlation between vaginal delivery, age and pelvic floor dysfunctions involving obstructed defecation is still a matter of controversy. OBJECTIVES: To determine the influence of age, mode of delivery and parity on the prevalence of posterior pelvic floor dysfunctions in women with obstructed defecation syndrome. METHODS: Four hundred sixty-nine females with obstructed defecation syndrome were retrospectively evaluated using dynamic 3D ultrasonography to quantify posterior pelvic floor dysfunctions (rectocele grade II or III, rectal intussusception, paradoxical contraction/non-relaxation of the puborectalis and entero/ sigmoidocele grade III). In addition, sphincter damage was evaluated. Patients were grouped according to age (<50y x >50y) and stratified by mode of delivery and parity: group I (<50y): 218 patients, 75 nulliparous, 64 vaginal delivery and 79 only cesarean section and group II (>50y): 251 patients, 60 nulliparous, 148 vaginal delivery and 43 only caesarean section. Additionally, patients were stratified by number of vaginal deliveries: 0 - nulliparous (n = 135), 1 - vaginal (n = 46), >1 - vaginal (n = 166). RESULTS: Rectocele grade II or III, intussusception, rectocele + intussusception and sphincter damage were more prevalent in Group II (P = 0.0432; P = 0.0028; P = 0.0178; P = 0.0001). The stratified groups (nulliparous, vaginal delivery and cesarean) did not differ significantly with regard to rectocele, intussusception or anismus in each age group. Entero/sigmoidocele was more prevalent in the vaginal group <50y and in the nulliparous and vaginal groups >50y. No correlation was found between rectocele and the number of vaginal deliveries. CONCLUSION: Higher age (>50 years) was shown to influence the prevalence of significant rectocele, intussusception and sphincter damage in women. However, delivery mode and parity were not correlated with the prevalence of rectocele, intussusception and anismus in women with obstructed defecation.

scholarly journals Prevalence of pelvic floor symptoms in female patients attending the two-week wait clinic with suspected colorectal cancer

2016 ◽  
Vol 98 (6) ◽  
pp. 413-418 ◽  
Author(s):  
J Bennett ◽  
A Greenwood ◽  
P Durdey ◽  
D Glancy
Keyword(s):  
Colorectal Cancer ◽  
Pelvic Floor ◽  
Pelvic Floor Dysfunction ◽  
Obstructed Defecation ◽  
Bowel Habit ◽  
Wexner Score ◽  
Exact Test ◽  
Female Patients ◽  
Presenting Symptoms ◽  
Pelvic Floor Symptoms

Introduction The aim of this study was to establish the prevalence of pelvic floor symptoms in women referred to a colorectal two-week wait (2WW) clinic with suspected colorectal cancer. Methods A questionnaire assessing faecal incontinence (FI) (Wexner score) and obstructed defecation syndrome (ODS) (Renzi score) was offered to 98 consecutive female patients attending a colorectal 2WW clinic at a single trust. Results Overall, 56 (57%) of the 98 patients had significant ODS and/or FI (scores >9/20), 33 (34%) had ODS and 40 (41%) had FI. Seventeen patients (17%) had both ODS and FI. Analysis of the 63 patients referred with a change in bowel habit (CIBH) showed 40 (63%) to be Renzi and/or Wexner positive compared with 16 (46%) of the 35 patients who presented without CIBH (p=0.095, Fisher’s exact test). Further analysis showed that 31 (78%) of the 40 patients with FI presented with CIBH compared with 32 (55%) of the 58 without FI (p=0.032). In terms of ODS, 23 (70%) of the 33 patients with ODS presented with CIBH compared with 40 (62%) of the 65 without ODS (p=0.506). Conclusions Over half of the female patients attending our colorectal 2WW clinic had significant pelvic floor dysfunction (FI/ODS), which may account for their symptoms (especially in the CIBH referral category). While it is important for malignancy to be excluded, many patients may benefit from investigation and management of their pelvic floor dysfunction as the cause for their presenting symptoms.

Comparison of pre and post-operative ODS (Obstructed Defecation Syndrome) score in patient with ODS undergoing Stapled Transanal Rectal Resection (STARR)

2020 ◽  
Vol 23 (2) ◽  
pp. 67-70
Author(s):  
Md Touhidul Islam ◽  
Shahadat Hossain Sheikh ◽  
Md Abu Taher ◽  
Tariq Akhter Khan ◽  
Md Ahsan Habib ◽  
...  
Keyword(s):  
Pelvic Floor ◽  
Rectal Resection ◽  
Obstructed Defecation ◽  
Surgical Approaches ◽  
Rectal Intussusception ◽  
Complication Rates ◽  
Stapled Transanal Rectal Resection ◽  
Obstructed Defecation Syndrome ◽  
Quasi Experimental ◽  
Surgery Department

Background: There are a variety of surgical approaches for correction of ODS, most of these have high recurrence and complication rates. Stapled transanal rectal resection (STARR) was introduced in 2003 by Antonio Longo as a minimally invasive transanal operation for ODS associated with rectocele and or rectal intussusception. Objective: This study was designed to assess the efficacy of Stapled Transanal Rectal Resection (STARR) as a surgical treatment of Obstructed Defecation Syndrome(ODS). Methodology: This is a quasi experimental study that was carried out at Colorectal surgery unit of surgery department in Bangabandhu Sheikh Mujib Medical University. The sample size was 17. The admitted patient of Obstructed Defecation Syndrome with Rectocele and or Rectal intussusception was selected according to inclusion and exclusion criteria. The patient was evaluated by history, clinical examination, proctoscopy, colonoscopy and defecography. Preoperative Longo’s ODS score was determined for each patient and it was compared with postoperative ODS score. Regular follow up was done for each patient at one, three and six months after each operation. Results: Significant improvement of ODS score was observed in 82.35% patients. Only 02 (11.8%) patients didn’t respond to STARR procedure and their postoperative score was 13-15 may be due to coexistence of pelvic floor dysynergy. Postoperative defecatory urgency developed only in 02(11.76%) patients. No patient developed significant postoperative complication like hemorrhage or rectovaginal fistula. Conclusion: STARR is a simple, less invasive and effective procedure for the treatment of ODS due to rectocele and/or rectal intussusception without major morbidity but pelvic floor dyssynergy should be excluded preoperatively because it’s presence makes the surgical intervention fruitless. Journal of Surgical Sciences (2019) Vol. 23(2): 67-70

Risk for symptomatic hemorrhage of cerebral cavernous malformations during pregnancy

2013 ◽  
Vol 118 (1) ◽  
pp. 50-55 ◽  
Author(s):  
M. Yashar S. Kalani ◽  
Joseph M. Zabramski
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Neurological Status ◽  
Common Symptom ◽  
Cerebral Cavernous Malformations ◽  
Sporadic Group ◽  
Cavernous Malformations ◽  
Female Patients ◽  
Patient Interviews ◽  
History Of

Object The threat of symptomatic hemorrhage from cerebral cavernous malformations (CCMs) during pregnancy remains poorly understood. The authors undertook this study to better define the risk of pregnancy-related hemorrhage in this population. Methods The records of female patients with sporadic (isolated lesions and negative family history) and familial forms of CCM, which were collected as part of the Barrow Neurological Institute CCM natural history study, were examined. Clinical data related to pregnancy, including type of delivery (vaginal or cesarean section) and any change in neurological status, were obtained from chart reviews and patient interviews. Results There were 168 pregnancies among 64 female patients with CCM (28 sporadic and 36 familial). Assuming an average of 46 weeks per pregnancy (40 weeks of gestation and 6 weeks of puerperium), patients were at risk for hemorrhage for a total of 148.6 years. Symptomatic hemorrhage (defined as new-onset or exacerbation of seizure activity or any change in neurological status) occurred during 5 pregnancies, with the most common symptom being seizures (4 cases). The overall risk for symptomatic hemorrhage was 3% per pregnancy; the risk was 1.8% per pregnancy in the sporadic group and 3.6% per pregnancy in the familial patients. There were 19 deliveries by cesarean section: 5 for obstetrical reasons, 8 for fear of possible hemorrhage, and 6 for unknown reasons. Vaginal delivery was performed without complications for the remaining 149 pregnancies. Conclusions The authors' experience suggests that the risk of symptomatic hemorrhage from a CCM during pregnancy is not increased and that a history of CCM is not a contraindication to pregnancy or vaginal delivery.

scholarly journals Pelvic floor biometry in asymptomatic primiparous women compared with nulliparous women: a single-center study in Southern China

2020 ◽  
Vol 48 (4) ◽  
pp. 030006052092039
Author(s):  
Yong-jiang Mao ◽  
Zhi-juan Zheng ◽  
Jie-hua Xu ◽  
Jing Xu ◽  
Xin-ling Zhang
Keyword(s):  
Cesarean Section ◽  
Pelvic Floor ◽  
Vaginal Delivery ◽  
Southern China ◽  
Valsalva Maneuver ◽  
Elective Cesarean Section ◽  
Nulliparous Women ◽  
Elective Cesarean ◽  
Primiparous Women ◽  
Ultrasound Parameters

Objective This study aimed to investigate pelvic floor biometry of asymptomatic primiparous women compared with nulliparous women by using four-dimensional transperineal ultrasound (4D TPUS). Methods From July 2015 to February 2017, 722 women were enrolled and divided into the nulliparous group (n = 292), the vaginal delivery group (n = 272), and the elective cesarean section group (n = 158). The ultrasound parameters of 4D TPUS were compared among the groups. Results The vaginal delivery group had a significantly greater bladder neck descent (η2 = 0.04), retrovesical angles on Valsalva maneuver (η2 = 0.01), urethral rotation (η2 = 0.01), levator hiatus area on Valsalva maneuver (η2 = 0.02), urethral inclination angle (η2 = 0.02), and funneling of the proximal urethra (η2 = 0.11) than the other two groups. Comparison of the two modes of delivery (vaginal delivery and cesarean section) also showed significant differences in the above-mentioned ultrasound parameters. Conclusion There are significant differences in pelvic floor biometry between asymptomatic primiparous women and nulliparous women, as well as between women with vaginal delivery and those with elective cesarean section.

Sign in / Sign up

Export Citation Format

Share Document