scholarly journals Functional Activity of the Internal Anal Sphincter Following Haemorroidectomy. A Long-term Manometric Study

2010 ◽  
Vol 16 (4/2010) ◽  
2009 ◽  
Vol 52 (11) ◽  
pp. 1895-1901 ◽  
Author(s):  
Osman Krand ◽  
Tunç Yalti ◽  
Gurkan Tellioglu ◽  
Melih Kara ◽  
Ibrahim Berber ◽  
...  

Gut ◽  
1986 ◽  
Vol 27 (1) ◽  
pp. 49-54 ◽  
Author(s):  
M Goldberg ◽  
M Hanani ◽  
S Nissan

2002 ◽  
Vol 16 (4) ◽  
pp. 249-257 ◽  
Author(s):  
Oliver M Jones ◽  
Alison F Brading ◽  
Neil J McC Mortensen

Recent research into the physiology and pharmacology of the internal anal sphincter has elucidated the importance of this structure in health and disease. Its pharmacological manipulation for therapeutic gain has focused mainly on agents to reduce internal anal sphincter tone, a ‘chemical sphincterotomy’ that might heal chronic anal fissure. However, drugs to increase sphincter tone, and augment intermittent and appropriate relaxation are also being evaluated. The initial results with this medical approach to anorectal disease have often been disappointing, failing to match the results achievable with surgery, and many of these drugs have a high rate of side effects in the short term. However, clinical trials have yet to establish the optimum doses, dose intervals and routes of administration for many of these therapies. Furthermore, it is uncertain whether this medical approach should be applied to all patients or just to an as yet undefined subgroup. Certainly, even in the current environment of uncertainty, there is little reason not to try medical manipulation of the internal sphincter as first-line treatment. Surgery remains an option for treatment failures; patients responding to pharmacological manipulation of the internal anal sphincter are spared the long term risks of continence that are inherent in many surgical procedures on the anorectum.


2006 ◽  
Vol 22 (3) ◽  
pp. 253-257 ◽  
Author(s):  
Rosalia Patti ◽  
Piero Luigi Almasio ◽  
Matteo Arcara ◽  
Massimiliano Sparacello ◽  
Stefania Termine ◽  
...  

2019 ◽  
Vol 23 (12) ◽  
pp. 1163-1172 ◽  
Author(s):  
M. R. Berg ◽  
H. Gregussen ◽  
Y. Sahlin

Abstract Background Sphincteroplasty is one of the treatment options for anal incontinence following obstetric injury. The aim of the study was to evaluate the long-term effect of sphincteroplasty with separate suturing of the internal and the external anal sphincter on anal continence. Methods A retrospective study was conducted on women who had sphincteroplasty for treatment of anal incontinence following obstetric injury. Women operated between January 1, 2011 and December 31, 2014 at Sykehuset Innlandet Hospital Trust Hamar, were invited to answer a questionnaire and participate in a clinical examination, including endoanal sonography. Results 111 (86.7%) women participated. Median postoperative follow-up was 44.5 months, and 63.8% of the participants experienced an improvement of at least three points in the St. Mark’s incontinence score. Fecal urgency and daily fecal leakage persisted in 39.4% and 6.4% of the participants, respectively. The internal anal sphincter improvement persisted in 61.8% of the participants, and there was a median reduction of their St. Mark’s score of 6.0 points between the preoperative value and the value at long-term follow-up. There was no significant change in the St. Mark’s score of patients with persistent dehiscence of the internal anal sphincter. Conclusions Sphincteroplasty, with separate suturing of the internal sphincter resulted in continence for stool maintained for at least 3 years in the majority of the patients, while there was an improvement in continence in nearly two-thirds.


2003 ◽  
Vol 42 (145) ◽  
pp. 54-58
Author(s):  
D S Malla

ABSTRACTThe professional literatures on the development of widely practiced procedure, episiotomy through theyears from the first publication in 1742 are reviewed. It reveals the change in number of publication as wellas the contributors to the development of perception about episiotomy. So it consisted expression of opinionof doctors initially then the co-workers like nurses and researchers and clients or consumers themselvestoo. It concludes that episiotomies prevent anterior perineal tear but fails to accomplish other benefitstraditionally ascribed to pelvic floor damage and relaxation including its sequel and also protection ofnewboin from intracranial haemorrhage and intrapartum asphyxia. Episiotomy substantially increasematernal blood loss during delivery and risk of anal sphincter damage with their long term morbidity.There is an urgent need to restrict the use of episiotomy in vaginal delivery.Key Words: Episiotomy, Perineal tear, anal sphincter damage.


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