scholarly journals FUNCTIONAL STATE OF THE PELVIC FLOOR MUSCLES IN PATIENTS WITH THE PELVIC PROLAPSE

2017 ◽  
pp. 55-61
Author(s):  
O. Yu. Fomenko ◽  
Yu. A. Shelygin ◽  
G. V. Poryadin ◽  
A. Yu. Titov ◽  
A. A. Ponomarenko ◽  
...  
Keyword(s):  
Physical Examination ◽  
Pelvic Floor ◽  
Anal Sphincter ◽  
Functional State ◽  
Diagnostic Algorithm ◽  
Pelvic Floor Muscles ◽  
Functional Study ◽  
Rectal Intussusception ◽  
Study Results ◽  
Obstructive Defecation

The article analyzes the functional state (evacuation functions, continence) and innervation of the pelvic floor muscles in patients with rectocele and combination rectocele with internal rectal intussusception, with complaints of obstructive defecation. AIM. The study of the functional state of the pelvic floor muscles in patients with obstructive defecation syndrome (ODS). MATERIALS AND METHODS. The study included 224 women with complaints of obstructive defecation, without pelvic floor surgery. On physical examination, all patients were detected signs of rectocele. The average age - 49,9±15,0 years. 52 (23,2%) patients had complaints to the fecal incontinence of various components. Diagnostic algorithm: physical examination defecography, rectal functional study (high resolution manometry (HRAM), evacuation test, comprehensive sphincterometry, pudendal nerve study). RESULTS. Frequency of functional disorders of defecation (FDD) according to objective methods of study among patients with ODS is high and amounts to 64.7%. In this case, there are no differences in the frequency FDD in patients with a combination of rectocele and internal intussusception compared to patients with only rectocele. There were no correlation between the frequency of anal sphincter failure and FDD. We identified some patients with subclinical incontinence, without complaints but with reduced manometric values and anal sphincter contractility. We have proved the absence of correlation between the presence or absence of pelvic floor muscle innervations violations in the form of neuropathy n. pudendus and the presence or absence of FDD. CONCLUSION. FDD can cause unsatisfactory results of surgical treatment of patients with ODS, even after the restoration of the anatomic relationships due to complaints of evacuation violation. ODS diagnostic algorithm should include not only an assessment of evacuationfunction (HRAM and evacuation test), but also sphincterometry, to assess the content function.

The functional state of the pelvic floor muscles in patients with rectocele

2017 ◽  
Vol 17 (3) ◽  
pp. 43 ◽  
Author(s):  
O. Yu. Fomenko ◽  
Yu. A. Shelygin ◽  
A. A. Popov ◽  
G. V. Poryadin ◽  
A. Yu. Titov ◽  
...  
Keyword(s):  
Pelvic Floor ◽  
Functional State ◽  
Pelvic Floor Muscles

Physiological and Hereditary Hyperbilirubinemia in Athletes: Role in Reducing Efficiency and Correction Methodology

2020 ◽  
Vol 5 (5) ◽  
pp. 386-393
Author(s):  
L. M. Gunina ◽  
◽  
Kazys Mylashyus ◽  
Voitenko V. L. ◽  
◽  
...  
Keyword(s):  
Physical Activity ◽  
Functional State ◽  
Oxygen Demand ◽  
Diagnostic Algorithm ◽  
Drug Prevention ◽  
The Body ◽  
Erythrocyte Membranes ◽  
Pharmacological Agents ◽  
Bilirubin Metabolism ◽  
The Individual

Under high-intensity loads, the athlete's bodies take place a number of biochemical reactions and physiological processes that can lead to hyperbilirubinemia. The factors that can initiate the onset of this phenomenon include the syndrome of micro-damage muscle, violation of the integrity of erythrocyte membranes, decreased blood pH, malnutrition and increase oxygen demand of the body. Degree of expression of manifestations of physiological bilirubinemia depends on the level of adaptation of the athlete to the physical activities offered. Hyperbilirubinemia in athletes can be one of the components of the deterioration of the functional state, forming the symptoms of endogenous intoxication. The relevance of this problem in sport lies in the relatively low detection rate of hyperbilirubinemia due to the lack of regular screening studies. However, in drawing up a plan of nutritional- metabolic support for training and competitive activity and recovery measures, must not only the individual reaction of the athlete body to physical activity, but also the severity of shifts in the indicators of bilirubin metabolism and their ratio. The article describes the reasons for the increase in bilirubin levels, which can be caused by both the effect of physical activity and by the presence of pathological processes in athletes. The factors influencing the blood serum’s bilirubin content are also highlighted, which include the state of erythrocyte cell membranes and the rate of hemoglobin destruction, the functional state of the liver, the specifics of physical loads and the use of ergogenic pharmacological agents by athletes. Particular accent has been placed on the illumination of hereditary hyperbilirubinemias, which may have been detected at the stage of selection of athletes. The most common phenomenon is Gilbert's syndrome, which occurs in 2-5% of cases in the general population, is characterized in the clinic by a benign flow and is manifested by episodes of jaundice and an increase in total bilirubin content to moderate values due to indirect. The frequency of detection of hyperbilirubinemias in the population of athletes is 4.68%, among which Gilbert's disease accounts for almost half (48.7%). Conclusion. The work highlighted the pathogenesis and diagnostic algorithm of Gilbert's disease, and also emphasized that its drug prevention and correction in athletes to maintain functional and physical fitness should be carried out taking into account anti-doping rules, which requires upon diagnosis timely receipt of a therapeutic exclusion

EPISIOTOMY : A CHALLENGING OBSTETRIC INTERVENTION

2003 ◽  
Vol 42 (145) ◽  
pp. 54-58
Author(s):  
D S Malla
Keyword(s):  
Blood Loss ◽  
Pelvic Floor ◽  
Anal Sphincter ◽  
Intracranial Haemorrhage ◽  
Perineal Tear ◽  
Obstetric Intervention ◽  
Anal Sphincter Damage

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.

scholarly journals Episiotomy: the biomechanical impact of multiple small incisions during a normal vaginal delivery

2019 ◽  
Vol 9 (5) ◽  
pp. 20190027 ◽  
Author(s):  
Dulce Oliveira ◽  
Maria Vila Pouca ◽  
João Ferreira ◽  
Teresa Mascarenhas
Keyword(s):  
Pelvic Floor ◽  
Pelvic Floor Dysfunction ◽  
Levator Ani ◽  
Symphysis Pubis ◽  
Pelvic Floor Muscles ◽  
Point Of View ◽  
Normal Vaginal Delivery ◽  
Tissue Integrity ◽  
Levator Trauma ◽  
Reaction Forces

Childbirth-related injuries are one of the main causes of pelvic floor dysfunction. To attempt to avoid serious tears during delivery, an episiotomy can be performed. In this study, we intended to investigate the biomechanical performance of the pelvic floor muscles after performing different episiotomies using a physics-based computational model which includes the pelvic floor muscles and the fetus. Previous biomechanical studies have analysed the mechanical effects of single incisions of different lengths; in this study, we intend to analyse the implications of multiple small incisions, evaluating the reaction forces, the stress on the muscles and the loss of tissue integrity sustained by the pelvic floor. The obtained results predict that an episiotomy delivery reduces the likelihood of macroscopic levator trauma by decreasing the stress on the region of insertion of the rectal area of the levator ani in the symphysis pubis . From the mechanical point of view, multiple incisions do not bring benefits compared to larger incisions. However, nothing can be ascertained about the clinical benefit of such an approach.

scholarly journals Age-associated changes in the mechanical properties of human cadaveric pelvic floor muscles

2020 ◽  
Vol 98 ◽  
pp. 109436 ◽  
Author(s):  
Lindsey A. Burnett ◽  
Mark Cook ◽  
Sameer Shah ◽  
Ms. Michelle Wong ◽  
Deborah M. Kado ◽  
...  
Keyword(s):  
Mechanical Properties ◽  
Pelvic Floor ◽  
Pelvic Floor Muscles
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