scholarly journals Insufficiency of the anal sphinter in women

2021 ◽  
pp. 70-75
Author(s):  
D. K. Muhabbatov ◽  
M. Q. Gulov ◽  
S. I. Rasulova ◽  
Sh. R. Amirov ◽  
J. J. Davlatov
Keyword(s):  
Research Methods ◽  
Anal Sphincter ◽  
Clinical Course ◽  
Organic Form ◽  
Related Factors ◽  
Wexner Score ◽  
Mixed Form ◽  
Sphincter Insufficiency ◽  
Functional Examination ◽  
Rectal Muscle

Aim. To analyze and assess the clinical course and changes under instrumental-functional examination (MRI) in the muscles of the obturator apparatus of the rectum in women with anal sphincter insufficiency (ASI).Material and methods. Clinical and instrumental research methods, as well as modern scales for assessing ASI (Wexner score scale), were used in the current study.Results and discussion. The study showed that 110 out of 228 patients with anal sphincter deficiency showed only an organic form of ASI, and 118 (51.8%) had a mixed form (organic and functional). This study shows that the degree of postpartum perineal rupture depends on the factors producing the damage to the pelvic floor muscles.Conclusion. Analysis of the clinical course of ASI in women showed that gender-related factors in 51.8% of cases contributed to the development of a mixed form of the disease. Functional research methods showed that along with the external and internal sphincters of the rectum, the pubo-rectal muscle is damaged in patients with ASI, which should be taken into account when choosing a treatment strategy for the mixed form of ASI.

Possibility of osteopathic correction inclusion in the complex treatment of anal incontinence in teenagers

2021 ◽  
pp. 31-40
Author(s):  
T. S. Kovalchuk ◽  
R. R. Enaleev ◽  
Yu. O. Kuzmina
Keyword(s):  
Anal Sphincter ◽  
Anal Incontinence ◽  
Standard Treatment ◽  
Control Group ◽  
Lumbar Region ◽  
Complex Treatment ◽  
Group 16 ◽  
Sphincter Insufficiency ◽  
Severity Of The Disease ◽  
Socially Maladjusted

Introduction. Anal incontinence (insufficiency of the anal sphincter) is a disease in which there is an uncontrolled discharge of intestinal contents through the anal canal when it is impossible to keep the episode of defecation to an acceptable place, which is a socially significant problem. Patients suffering from anal incontinence experience a feeling of psychoemotional inferiority and are often socially maladjusted. Insufficiency of the anal sphincter is a widespread pathology. The course of therapy is, as a rule, complex, and usually includes the use of medications, cleansing enemas, as well as non-drug methods of treatment (exercise therapy, massage, physiotherapy). At the same time, information on the possibility of including such a method of non-drug treatment as osteopathic correction in the complex therapy of anal incontinence in the available literature has not been found.The aim of the research was to study the possibility of including osteopathic correction in the complex treatment of anal sphincter insufficiency in teenagers.Materials and methods. The study involved 32 teenagers with functional anal sphincter incontinence, aged 14–17 years, undergoing treatment in the department of surgery. The patients were divided into 2 groups by the method of simple randomization — the main group (16 people, they received osteopathic correction in addition to the standard treatment) and the control group (16 people, they received only the standard treatment). At the beginning and at the end of the study there were assessed the osteopathic status and the disease severity using the Wexner scale and the Browning–Parks scale. The obtained results were analyzed by methods of nonparametric statistics. Results. It was found that the inclusion of osteopathic correction in the complex treatment of teenagers with anal sphincter insufficiency is accompanied by a statistically significant (p<0,05) decrease in the severity of the disease. It was revealed that children suffering from anal sphincter insufficiency are characterized by a high frequency of detection of regional (pelvic region, lumbar region) and local (some skull sutures, rectum, ascending and descending colon) somatic dysfunctions. After osteopathic correction, the frequency of detecting regional and local dysfunctions in teenagers is statistically significantly lower (p<0,05) compared with children who did not receive osteopathic correction.Conclusion. The obtained results demonstrated the ability to include the osteopathic correction in the complex treatment of teenagers with anal sphincter insufficiency.

scholarly journals Factors affecting the course of body and kidney growth in infants with urolithiasis: A critical long-term evaluation

2016 ◽  
Vol 88 (4) ◽  
pp. 249 ◽  
Author(s):  
Kemal Sarica ◽  
Fatma Narter ◽  
Kubilay Sabuncu ◽  
Ahmet Akca ◽  
Utku Can ◽  
...  
Keyword(s):  
Breast Feeding ◽  
Clinical Course ◽  
Stone Disease ◽  
The Body ◽  
Renal Growth ◽  
Related Factors ◽  
Growth Status ◽  
Long Term Follow Up

Objective: To investigate the possible effects of dietary, patient and stone related factors on the clinical course of the stone disease as well as the body and renal growth status of the infants. Patients and Methods: A total of 50 children with an history of stone disease during infancy period were studied. Patient (anatomical abnormalities, urinary tract infection - UTI, associated morbidities), stone (obstruction, UTI and required interventions) and lastly dietary (duration of sole breast feeding, formula feeding) related factors which may affect the clinical course of the disease were all evaluated for their effects on the body and renal growth during long-term follow-up. Results: Mean age of the children was 2.40 ± 2.65 years. Our findings demonstrated that infants receiving longer period of breast feeding without formula addition seemed to have a higher rate of normal growth percentile values when compared with the other children. Again, higher frequency of UTI and stone attacks affected the growth status of the infants in a remarkable manner than the other cases. Our findings also demonstrated that thorough a close follow-up and appropriately taken measures; the possible growth retardation as well as renal growth problems could be avoided in children beginning to suffer from stone disease during infancy period. Conclusions: Duration of breast feeding, frequency of UTI, number of stone attacks and stone removal procedures are crucial factors for the clinical course of stone disease in infants that may affect the body as well as kidney growth during long-term follow-up.

ULTRASOUND DIAGNOSTICS OF CHRONIC CONSTIPATION IN CHILDREN: RESULTS OF A CLINICAL STUDY

2021 ◽  
Vol 100 (6) ◽  
pp. 59-65
Author(s):  
L.N. Tsvetkova ◽  
◽  
M.M. Kolisnichenko ◽  
O.A. Goryacheva ◽  
◽  
...  
Keyword(s):  
Clinical Study ◽  
Anal Sphincter ◽  
Chronic Constipation ◽  
Diagnostic Method ◽  
Age Distribution ◽  
Age Groups ◽  
Pathological Process ◽  
Number Of Patients ◽  
Ultrasound Diagnostics ◽  
Sphincter Insufficiency

Chronic constipation (CC) is an important medical and social problem, as it can lead to the development of complications, fecal intoxication, social disadaptation and self-isolation of a child, as well as significantly reduce the quality of life. The article presents the results of a clinical study of CC in children using a new diagnostic method - transabdominal and transperianal ultrasound examination (US) of the colon and anorectal zone. The objective of the study was to analyze the course of CC in children depending on the mechanism of its formation according to US of the colon and anorectal zone. Materials and methods of research: the prospective cohort study included 470 children with an established diagnosis of CC at the age of 1 month to 17 years old. The patients were divided into 3 age groups: 1 month. – 3 years (n=166), 4–10 years (n=102), 11–17 years (n=202). The median follow-up was 48 months. The age distribution of children with CC was carried out on the basis of the frequency of visits, against the background of the beginning of attending kindergarten and/or elementary school groups, and the emergence of psychological problems due to the difficulty of going to a public toilet. An evaluation of analysis of the dynamics of US changes in the colon and anorectal zone was carried out by the method of ultrasound diagnosis of Hirschsprung's disease in children (patent № 2547614, authors M.I. Pykov, M.M. Kolisnichenko, I.V. Poddubny). Results: in children aged 1 month to 3 years, 66.9% of cases are statistically significantly dominated by proctogenic constipation type of constipation with US signs of anus spasm and anal sphincter insufficiency. In children aged 4 to 10 years, the mixed mechanism of CC formation prevails (41.1%), and in patients aged 11 to 17 years – cologenic (77.7%), for which the most typical ultrasound signs are dolichocolon (22.8%), anus spasm (8.7%), anal sphincter insufficiency (4.7%). It has been established that despite adequate therapy, the number of patients with the above-described mechanisms of formation of CC increases, which indicates the recurrence and progression of pathological process in children of different age groups. Conclusion: the proposed diagnostic method – transabdominal and transperianal US of the colon and anorectal zone is a highly informative, pathogenetically substantiated method for examining the state of the colon and anorectal zone in children with CC, built on precise objective criteria that are available at any age.

Turnover decisions of women accountants: using personal histories to understand the relative influence of domestic obligations

2009 ◽  
Vol 14 (1-2) ◽  
pp. 55-78 ◽  
Author(s):  
Margaret G. Lightbody
Keyword(s):  
Research Methods ◽  
Turnover Intentions ◽  
Complex Interaction ◽  
Related Factors ◽  
Narrative History ◽  
Factors Influencing ◽  
Clear Link ◽  
Personal Histories ◽  
Study Participants ◽  
Actual Turnover

Studies of accountants' turnover intentions have been unable to demonstrate a clear link between conventional job-related antecedents and women's higher rates of turnover. This study utilizes narrative histories of three women, including the author herself, who have exhibited actual turnover behaviour to examine the factors underpinning their turnover decisions. The findings demonstrate that while the study participants did identify job related factors, their turnover decisions were more significantly influenced by a complex interaction of job and domestic factors. This article thus recommends that an understanding of women's turnover decisions must first utilize research methods such as narrative history that allow the complexity of factors influencing their decisions to be identified and second, must incorporate greater consideration of specific domestic drivers of the cumulative workload/stresses of both job and domestic factors.

scholarly journals CLINICAL AND MANOMETRIC ASSESMENT OF FUNCTIONAL STATE OF ANAL SPHINCTER IN PATIENTS AFTER FISTULECTOMY WITH PRIMARY SPHINCTEROPLASTY

2018 ◽  
pp. 31-38 ◽  
Author(s):  
I. V. Kostarev ◽  
O. Yu. Fomenko ◽  
A. Yu. Titov ◽  
L. A. Blagodarni ◽  
S. V. Belousova ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Fecal Incontinence ◽  
Anal Sphincter ◽  
Anorectal Manometry ◽  
Clinical Symptoms ◽  
Normal Pressure ◽  
Wilcoxon Test ◽  
Anal Pressure ◽  
Wexner Score ◽  
Resting Anal Pressure

AIM: to evaluate changes of anorectal manometry parameters and clinical symptoms of fecal incontinence 3 months after fistulectomy with primary sphincteroplasty. MATERIALS AND METHODS: fifty-two patients (37 males) with complex anal fistulae of cryptoglandular origin underwent fistulectomy and primary sphincteroplasty. The fistulas were recurrent in 13 (25 %) cases, 8 (15,4 %) patients had preoperative fecal incontinence. Fecal incontinence Wexner score was 0,46 (0-8) before surgery. Anorectal manometry was performed before and 3 months after surgery. RESULTS: three months days after surgery mean and maximum resting anal pressure were not significantly low compared with the baseline. In patients with initially normal data before the surgery (n=22), resting anal pressure was significantly lower (before surgery M=56,1 ± 7,6 [46,1-69,0], after surgery 45,5 ± 8,8 [38,0-63,0], p=0,006, Wilcoxon test). There were no significant changes in squeezing anal pressure. Resting anal pressure has become below the normal after surgery in 13 (59.1 %) patients. Clinical symptoms of fecal incontinence was detected in 10 patients postoperatively (gas incontinence and soiling). Fecal incontinence Wexner score was 1,64 (0-11) after surgery (p=0,007). CONCLUSION: fistulectomy with primary sphincteroplasty leads to change of resting anal pressure basically in patients with initially normal pressure and mainly - in patients with anterior fistulas. Fecal incontinence symptoms after with surgery produced 26,3 % patients. These data confirm the need of individual approach when choosing the method of surgical treatment of analfistulae.

scholarly journals THE EXPERIENCE OF LIGATION OF INTERSPHINCTERICFISTULA TRACT IN THE TREATMENT OF PATIENTS WITH TRANS- AND SUPRASPHINCTERIC ANAL FISTULAE

2016 ◽  
pp. 47-53
Author(s):  
A. Yu. Titov ◽  
I. V. Kostarev ◽  
I. S. Anosov ◽  
O. Yu. Fomenko
Keyword(s):  
Success Rate ◽  
Anal Sphincter ◽  
Anal Incontinence ◽  
Anorectal Manometry ◽  
Healing Rate ◽  
Fistula Tract ◽  
Anal Continence ◽  
Wexner Score ◽  
Is Evaluation

AIM. Ligation of intersphinctericfistllа tract (LIFT) is a new sphincter-preserving technique avoiding development of anal incontinence. The aim of the study is evaluation of effectiveness of this procedure. METHOD. From Jan 2013 to Dec 2015 40 patients with anal fistulae, exciting more than 30% of anal sphincter was included in the study. Male: 28 (70%), Female: 12 (30%). 29 (72,5%) cases were middle transsphincteric, 16 (22,5%) - deep transsphincteric and 2 (5%) was suprasphincteric. RESULTS. The median follow up was 16 months ((3-36) months). The healing rate was (72,5%). Recurrents developed in 5 (17,3%) patients with middle transsphincteric fistulae, 5 (55,6%) - with deep transsphincteric fistulae, and 1 (50%) with suprasphincteric fistulae. 4 patients developed an intersphincteric abscess. After excision of this fistulae healing occurred in all four cases. A second operation did not affect the function of anal continence. At follow-up there was no change in continence evaluated by Wexner score and anorectal manometry. CONCLUSION. LIFT has a high success rate in middle transsphinteric anal fistulae. Recurrence is related to deep portion fistulae or suprasphinteric fistula tract.

scholarly journals POST-TRAUMATIC ANAL SPHINCTER INSUFFICIENCY

2017 ◽  
pp. 52-54
Author(s):  
A. V. Muravyev ◽  
V. I. Linchenko ◽  
K. A. Muravyev ◽  
P. I. Chumakov ◽  
C. І. Petrosyans ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Anal Sphincter ◽  
Conservative Therapy ◽  
Surgical Care ◽  
Emergency Procedure ◽  
Sphincter Injury ◽  
Defunctioning Stoma ◽  
Wound Debridement ◽  
Post Traumatic ◽  
Sphincter Insufficiency

AIM. To develop tactics of treatment for post-traumatic anal sphincter insufficiency in emergency surgery. MATERIALS AND METHODS. 472 patients with anal sphincter insufficiency were treated between 1977-2015. Of them 125 had conservative therapy. Surgical treatment was performed in 347 patients. Twenty-four patients had emergency procedure. RESULTS AND CONCLUSIONS. The success of the rehabilitation of these patients depends on the timely and adequate surgical care at the time of the sphincter injury. 3 degrees of perineum tears in labor should be sutured by experienced obstetricians and only in layers. Sphincteroplasty without colostomy is indicated within 24 hours after injury, while later admission ot hospital requires defunctioning stoma. Gunshot sphincter damage require wound debridement without sphincteroplasty and defunctioning stoma.

scholarly journals COMPARISON OF MODIFIED METHOD OF LIGATION OF INTERSPHINCTERIC FISTULA TRACT (LIFT) AND STANDARD OPERATIONS IN PATIENTS WITH TRANSSPHINCTERIC RECTAL FISTULAS

2019 ◽  
Vol 6 (2) ◽  
pp. 82-87
Author(s):  
Igor Kryvoruchko ◽  
Tetiana Firsyk ◽  
Oleksandr Bozhko
Keyword(s):  
Surgical Treatment ◽  
Anal Sphincter ◽  
Standard Procedure ◽  
Fistula Tract ◽  
Anal Fistulas ◽  
Modified Method ◽  
Intersphincteric Fistula ◽  
Sphincter Insufficiency ◽  
Standard Operations

COMPARISON OF MODIFIED METHOD OF LIGATION OF INTERSPHINCTERIC FISTULA TRACT (LIFT) AND STANDARD OPERATIONS IN PATIENTS WITH TRANSSPHINCTERIC RECTAL FISTULAS Kryvoruchko I.A. , Firsyk T.M.,.  Bozhko O. P. Background. The search for and development of new minimally invasive methods for the surgical treatment of anal fistulas is a relevant area of surgery. Such methods combine less traumatization and preservation of the sphincter’s complex. Employment of such methods for surgical treatment of anal fistulas reduced the time of stay of patients in the hospital and improved their quality of life. Subjects and methods. A retro- and prospective study involved 58 patients with uncomplicated transsphincteric anal fistulas. All patients were treated in the hospital from January 2014 to April 2019.  The patients were divided into two groups: the first group included 32 patients who were operated on according to the standard procedure using fistulotomy and Seton procedure; the second group consisted of 26 patients who were operated on using the modified LIFT method. Results. Most of these patients (72.4%) were men at the age of 42.536.79. The median of BMI was 25.7 kg/m2. There wasn’t mortality after operations. The median follow-up was 21 (6-48) weeks. In the first group there were 3 cases (9.3%) of anal sphincter insufficiency and 7 cases of recurrent fistulas (21.9%) at different times after surgery.  In the second group there were no anal sphincter failure following administration of the modified method LIFT, but there were 15.4% of recurrent anal fistulas. Conclusion. The proposed modified method of ligation of intersphincteric fistula tract is an effective method for the treatment of anal fistulas. The results obtained suggest that the developed method can be used to treat other types of anal fistulas.  Keywords: transsphincteric anal fistula, surgical treatment, LIFT technique, postoperative complications.   Резюме. ПОРІВНЯННЯ МОДИФІКОВАНОГО МЕТОДУ ЛІГАЦІЇ ІНТЕРСФІНКТЕРНОГО  ФІСТУЛЬНОГО ТРАКТУ (LIFT) ТА СТАНДАРТНИХ ОПЕРАЦІЙ У ХВОРИХ З ТРАНСФІНКТЕРНИМИ РЕКТАЛЬНИМИ СВИЩАМИ Криворучко I.A., Фірсик Т.М., Божко О. П. Вступ. Пошук та розробка нових малоінвазивних методів хірургічного лікування анальних свищів є актуальною областю хірургії. Такі методи поєднують меншу травматизацію і збереження сфінктерного комплексу прямої кишки. Застосовання таких методів хірургічного лікування анальних свищів скоротило час перебування хворих у стаціонарі і поліпшило їх якість життя. Об'єкт  і методи.  Ретро- і проспективне дослідження було проведено у 58 пацієнтів з неускладненими транссфінктерними анальними свищами. Всі пацієнти проходили лікування в лікарні з січня 2014 року по квітень 2019 року. Пацієнти були розділені на дві групи: перша група включала 32 пацієнтів, яких оперували за стандартною процедурою з використанням фістулотомії та процедури Сетона; другу групу склали 26 хворих, яких оперували за допомогою модифікованого нами способу лігування інтрасфінктерного фістульного тракту (LIFT). Результати. Більшість цих пацієнтів (72,4%) були чоловіками у віці 42,536,79  років.  Медіана ІМТ склала 25,7 кг/м2.  Після операцій летальних випадків не було. Медіана спостереження після операції склала 21 (6-48) тиждень. У першій групі ми отримали 3 випадки (9,3%) недостатності анального сфінктеру і у 7 випадках  рецидив свищів (21,9%) в різний час після операції. У другій групі після застосування модифікованого методу LIFT ми не отримали жодної недостатності анального сфінктеру, але у цих пацієнтів спостерігалося 15,4% рецидивів анальних свищів. Висновок. Запропонований модифікований спосіб лігування інтрасфінктерного фістульного тракту є ефективним методом лікування анальних свищів. Отримані результати свідчать про те, що розроблений метод може бути використаний для лікування інших видів анальних свищів. Ключові слова: транссфінктерні анальні свищі, хірургічне лікування, техніка LIFT, післяопераційні ускладнення.   Резюме. СРАВНЕНИЕ МОДИФИЦИРОВАННОГО МЕТОДА ЛИГАЦИИ ИНТЕРСФИНКТЕРНОГО ФИСТУЛЬНОГО ТРАКТА (LIFT) И СТАНДАРТНЫХ ОПЕРАЦИЙ У БОЛЬНЫХ С ТРАНСФИНКТЕРНИМЫ РЕКТАЛЬНЫМИ СВИЩАМИ Криворучко I.A., Фирсик Т.М., Божко А. П.  Введение. Поиск и разработка новых малоинвазивных методов хирургического лечения анальных свищей является актуальной проблемой хирургии. Такие методы сочетают в себе меньшую травматизацию и сохранение сфинктерного комплекса прямой кишки. Применение таких методов хирургического лечения анальных свищей сократило время пребывания больных в стационаре и улучшило их качество жизни. Объект и методы. Ретро- и проспективное исследование было проведено у 58 пациентов с неосложненными транссфинктерными анальными свищами. Все пациенты проходили лечение в больнице с января 2014 по апрель 2019 года. Пациенты были разделены на две группы: первая группа включала 32 пациентов, оперированных по стандартной процедуре с использованием фистулотомии и процедуры Сетона; вторую группу составили 26 больных, оперированных с помощью модифицированного нами способа лигирования интрасфинктерного фистульного тракта (LIFT). Результаты. Большинство этих пациентов (72,4%) были мужчинами в возрасте 42,536,79 лет. Медиана ИМТ составила 25,7 кг/м2. После операций летальных исходов не было. Медиана наблюдения после операции составила 21 (6-48) неделю. В первой группе мы получили 3 случая (9,3%) недостаточности анального сфинктера и в 7 случаях  рецидив свищей (21,9%) в разное время после операции. Во второй группе после применения модифицированного метода LIFT мы не получили ни недостаточности анального сфинктера, но у этих пациентов наблюдалось 15,4% рецидивов анальных свищей. Вывод. Предложенный модифицированный способ лигирования интрасфинктерного фистульного тракта является эффективным методом лечения анальных свищей. Полученные результаты свидетельствуют о том, что разработанный метод может быть использован для лечения других видов анальных свищей. Ключевые слова: транссфинктерные анальные свищи, хирургическое лечение, техника LIFT, послеоперационные осложнения

scholarly journals POS1348 MORTALITY AND ITS RELATED FACTORS IN PATIENTS WITH IGG4-RELATED DISEASE: A JAPANESE SINGLE-CENTER STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 956-957
Author(s):  
I. Mizushima ◽  
H. Kawahara ◽  
T. Yoshinobu ◽  
S. Shin ◽  
R. Hoshiba ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Cox Regression ◽  
Clinical Course ◽  
Regression Analyses ◽  
Related Factors ◽  
Related Disease ◽  
Igg4 Related Disease ◽  
Crude Mortality Rate ◽  
Crude Mortality

Background:In recent years, IgG4-related disease (IgG4-RD) has become a widely recognized disorder. However, mortality and its related factors in this disease are not well known.Objectives:This study aimed to clarify mortality and its related factors in patients with IgG4-RD.Methods:We retrospectively reviewed the medical records of patients with IgG4-RD diagnosed by experts based on fulfillment of the Japanese comprehensive diagnostic criteria and/or the 2019 ACR/EULAR classification criteria for IgG4-RD at a single center in Japan. Using the collected data, we calculated the crude mortality rate and the standardized mortality ratio (SMR) using national Japan mortality statistics and investigated the cause of death. We performed Cox regression analyses to assess mortality-related factors.Results:A total of 179 patients with IgG4-RD were included: 124 were male (69.3%); the median age was 68 years (interquartile range [IQR] 60-75 years); and the median follow-up from diagnosis was 47 months (IQR 17-84). Ten patients (5.6%) in our cohort died during the follow-up period. Five died of malignancy, one of respiratory failure, two of infectious pneumonia, one of sudden cardiac event, and one of suspected aortic aneurysmal rupture. The crude mortality rate was 11.1 per 1,000 person-years. According to national Japan mortality statistics, 11.6 age- and sex-matched deaths were expected to occur within the follow-up period, resulting in a SMR of 0.86 (95% confidence interval [CI] 0.41-1.59). Univariate Cox regression analyses indicated that the number of affected organs at diagnosis (hazard ratio [HR] 1.45, 95% CI 1.02-2.05), serum creatinine levels at diagnosis (HR 1.82, 95% CI 1.06-3.12), and the presence of malignancy during the clinical course (HR 3.93, 95% CI 1.10-14.02) had a significant impact on the time to death, whereas the other factors including age at diagnosis and serum C-reactive protein and IgG4 levels at diagnosis did not.Conclusion:Our findings suggest that the mortality rate of patients with IgG4-RD does not significantly differ from that of the Japanese general population. Multi-organ involvement and renal dysfunction at diagnosis as well as malignancy during the clinical course may be associated with higher mortality. An appropriate clinical evaluation for the early detection of these risk factors is required at first diagnosis and during long-term follow-up.Disclosure of Interests:None declared

scholarly journals SPHINCTEROMETRY GRADATION OF ANAL SPHINCTER INSUFFICIENCY

2016 ◽  
pp. 54-59 ◽  
Author(s):  
Yu. A. Shelygin ◽  
A. Yu. Fomenko ◽  
A. Yu. Titov ◽  
E. A. Berseneva ◽  
A. A. Mudrov ◽  
...  
Keyword(s):  
Anal Sphincter ◽  
Sphincter Insufficiency
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