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Biomedical subjects

J Bjarnesen

Publications and source records attributed to J Bjarnesen.

5 recordsLinked to original sources
PubMed1999

Anal incontinence after obstetric third- /fourth-degree laceration. One-year follow-up after pelvic floor exercises.

The study was a 1-year follow-up of 48 women with obstetric third- /fourth-degree perineal laceration. After primary surgical repair the symptomatic patients were treated with pelvic floor exercises with or without transanal electrical stimulation. Various methods for assessing anal sphincter function were also evaluated. One month postpartum 10 women (21%) complained of anal incontinence, 8 for flatus only; 1 patient was reoperated on. After 1 year none complained of fecal incontinence, and 3 (7%) complained of flatus incontinence. We found relatively few women with anal incontinence after third- /fourth-degree laceration. The pelvic floor training program was effective, but electrical stimulation was abandoned because of anal pain. Grade IIIb lesion, dilution of the sphincter at anal ultrasonography, and sphincter weakness at palpation were significantly related to symptoms of anal incontinence. For routine follow-up after third- /fourth-degree laceration, palpation of the anal sphincter and pelvic floor seems sufficient as first-line assessment.

Adult↗
PubMed1994

[Sphincter rupture in the course of labor].

Thirty-eight women with anal sphincter rupture during childbirth were followed for three to 12 months. Fourteen patients presented with continence disturbances, nine to solid or fluid faeces and five to gas. Incontinence was present in nine patients three months after childbirth. Anal manometry and anal electromyography were performed on the patients three to five days after delivery and repeated at three, six and twelve months after childbirth. Manometry and electromyography were performed on 16 control subjects and 24 primiparous control patients who were investigated three to five days and three months after delivery. Anal manometry and anal electromyography showed significant differences between both incontinent and continent patients compared to control subjects and primiparous control patients. Primiparous control patients had decreased squeeze pressure as well as decreased electromyographic activity during the first days after delivery compared to control subjects. After three months no differences were found. Continence disturbances are frequent after sphincter rupture and these patients should be monitored after delivery and those with persisting incontinence offered sphincter repair.

Adult↗
PubMed1993

Sphincter rupture in childbirth.

Thirty-eight women with rupture of the anal sphincter occurring during childbirth were followed for 3-12 months. Nineteen had complete rupture of the external anal sphincter, 14 had a lesion involving more than half of the sphincter muscle and five had a superficial rupture. Fourteen patients presented with continence disturbances: nine to solid or liquid faeces and five to flatus. Incontinence was present in nine women 3 months after childbirth. Anal manometry and electromyography were performed in patients 3-5 days after delivery and repeated at 3, 6 and 12 months. Manometry and electromyography were also performed in 16 control subjects who were nulliparous or had given birth more than 2 years previously and 24 primiparous controls, who were investigated at 3-5 days and at 3 months. There were significant differences between both incontinent and continent patients compared with nulliparous and primiparous controls. Primiparous control subjects had decreased anal squeeze pressure as well as decreased electromyographic activity on the first days after delivery compared with nulliparous controls. After 3 months no differences were found. Continence disturbances are frequent after sphincter rupture; these patients should be monitored after delivery and those with persisting incontinence offered sphincter repair.

Adolescent↗
PubMed1991

[Postoperative urinary retention].

Postoperative retention of urine (PU) is a common complication which may occur after any surgical intervention. It may affect both sexes in all age groups and result in considerable morbidity. The frequency depends upon the type of operation and its duration but statements in the literature vary greatly on account of inaccurate and varying definitions and uncertain diagnostic criteria. Intervention in the true pelvis results in the highest frequencies of postoperative urinary retention. The method of anesthesia is of lesser significance. Spinal anesthesia and epidural morphine constitute, however, a particular risk for the development of postoperative retention of urine. The pathological physiology is complex and includes: 1) disturbance of the balance between the sympathetic/parasympathetic influence on bladder and urethral function, 2) drugs which inhibit the miction reflex, 3) anaesthesia and sedation which cloud the awareness of bladder filling, 4) rapid filling of the bladder with subsequent overdistension, 5) lesion of the nerve fibres to the lower urinary tract, 6) mechanical obstruction and 7) difficult positions and/or situations for miction. Preoperative information about difficulty in emptying the bladder constitutes a predisposing factor and may require preoperative elucidation and treatment. Postoperative retention of urine may be countered by informative and practical measures and restriction of fluid intake. In selected cases, prophylactic treatment with alpha-blockers and prostaglandin may reduce the frequency. Therapeutically, oral parasympathomimetica do not appear to be effective while alpha-blockers may be employed. In cases where catheter treatment is employed and which is anticipated to be required for more than 48 hours, suprapubic drainage is recommended as this results in fewer cases of urinary infection than transurethral indwelling catheters.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗