PubMed Health⌕ Search

Biomedical subjects

R Ganansia

Publications and source records attributed to R Ganansia.

17 recordsLinked to original sources
PubMed2001

[Anal incontinence].

Contrary to a widespread opinion, anal incontinence is a frequent condition in men and women, and not only a disease of advanced age. This condition is so devastating socially and personally that the afflicted individual is often too embarrassed to bring it to the attention of his physician. An accurate history, a physical examination and additional anorectal physiology testing (anorectal manometry and anal endosonography) document the aetiology. The first line of treatment is medical including bowel management and neuromuscular reeducation. In case of failure, according to the cause, and with due regard to the impact on the quality of life, surgery can be performed. It is essential to know the preventive measures which are the only means for decreasing the incidence of anal incontinence.

Adult↗
PubMed2000

Are sphincter defects the cause of anal incontinence after vaginal delivery? Results of a prospective study.

PURPOSE: Anal incontinence affects approximately 10 percent of adult females. Damage to the anal sphincters has been considered as the cause of anal incontinence after childbirth in the sole prospective study so far available. The aims of the present study were to determine prospectively the incidence of anal incontinence and anal sphincter damage after childbirth and their relationship with obstetric parameters. METHODS: We studied 259 consecutive females six weeks before and eight weeks after delivery. They were asked to fill in a questionnaire assessing fecal incontinence. Anal endosonography (7-10 MHz) was then performed. Two independent observers analyzed internal and external anal sphincters. RESULTS: A total of 233 patients (90 percent) were assessed, of whom 31 had cesarean section. De novo sphincter defects were observed in 16.7 percent (14 percent external, 1.7 percent internal, and 1 percent both) in the postpartum period only after vaginal delivery. These disruptions occurred with the same incidence after the first and the second childbirth. Independent risk factors (odds ratio; 95 percent confidence interval) for sphincter defect were forceps (12; 4-20), perineal tears (16; 9-25), episiotomy (6.6; 5-17), and parity (8.8; 4-19) as revealed by multivariate analyses. The overall rate of anal incontinence was 9 percent and independent risk factors (odds ratio; 95 percent confidence interval) involved forceps (4.5; 1.5-13), perineal tears (3.9; 1.4-10.9), sphincter defect (5.5; 5-15), and prolonged labor (3.4; 1-11). Among these patients only 45 percent had sphincter defects. CONCLUSION: Anal incontinence after delivery is multifactorial, and anal sphincter defects account for only 45 percent of them. Primiparous and secundiparous patients have the same risk factors for sphincter disruption and anal incontinence. Because external anal sphincter disruptions are more frequent than internal anal sphincter damage, surgical repair should be discussed in symptomatic patients.

Adolescent↗
PubMed2000

[Postpartum sphincter rupture and anal incontinence: prospective study with 259 patients].

AIMS: Damage to the anal sphincter has been considered as the cause of anal incontinence after childbirth. The aims of the present study were to determine prospectively the incidence of anal incontinence and anal sphincter damage after childbirth, and their relationship with obstetric parameters in France. PATIENTS AND METHODS: We studied 259 consecutive women six weeks before and eight weeks after delivery. They were asked to fill out a questionnaire dealing with faecal and urinary incontinence. Anal endosonography (B&K 7-10 MHz) was then performed. Two independent observers analyzed internal and external anal sphincters. RESULTS: Two hundred and thirty-three women (90%) were assessed, among whom 31 had had a caesarean section. De novo sphincter defects were observed in 19.3% (39 patients) in the postpartum period only after vaginal delivery (202 patients). These disruptions occurred with the same incidence after the first and second childbirth. Independent risk factors (odds ratio; 95% confidence interval) for sphincter defect were forceps (odds ratio 11.9; 4.8-33.3), perineal tears (odds ratio 16.1; 4.4-83.9), episiotomy (odds ratio 6.6; 1.7-34.2), and pauciparity < or = 2 (odds ratio 8.8; 1-78.3), as revealed by multivariate analyses. The overall rate of de novo anal incontinence was 9% (20 patients), and independent risk factors involved forceps (odds ratio 4.5; 1.5-13), perineal tears (odds ratio 3.9; 1.4-10.9), de novo sphincter defect (odds ratio 5.5; 5-15) and prolonged labor (odds ratio 3.4; 1-11). Among the 20 women who had de novo anal incontinence, only 45% (9 patients) had sphincter defects. CONCLUSION: De novo anal incontinence after delivery is multifactorial and anal sphincter defects account only for 50% of them. Primiparous and secundiparous women have the same high-risk factor for sphincter disruption and anal incontinence. Since external anal sphincter disruptions are more frequent than internal anal sphincter damage, surgical repair should be discussed.

Adolescent↗
PubMed1994

Rare anorectal pathologic conditions.

Among the rare anorectal pathologic conditions published in the literature since 1992, except for malignant pathology, we have taken an interest in anal dermatology with Hailey-Hailey disease; infectious diseases, including tuberculosis, gangrene, actinomycosis, and cytomegalovirus ulcerations; vascular pathology with rectal varices and tumoral pathology with leiomyomas and lipomas; embryologic disorders, including gastric and salivary heterotopia; and a few exceptional lesions, such as spontaneous hematomas and certain traumatic lesions.

Anal Canal↗
PubMed1992

Anorectal lesions in human immunodeficiency virus-infected patients.

In a prospective study, we analysed the anorectal lesions observed in 148 human immunodeficiency virus-infected patients and compared the data with those reported in the literature. The majority of the patients (97.3%) were homosexual or bisexual men. The mean age of the population was 34.2 years. A history of previous sexually transmitted diseases was found in 79.7% of the male patients. The stage of HIV-related disease, according to the Centers for Disease Control classification, could be determined in 141 patients: 54.6% were stage II, 3.5% stage III and 41.8% stage IV. Anal condylomata were the most frequent manifestation, affecting 29.7% of the patients, 7.1% of whom showed moderate to severe dysplasia. The types were mainly 6, 11, 16 and 18, but types 31, 35 and 39 were also observed. Ulcerations were the most frequent non-condylomatous lesions, occurring in 41 patients; most (60%) were due to herpes viruses, and a large minority (21%) to cytomegalovirus. The etiology could not be determined in five cases. Anal sepsis was present in 11.4%, haemorrhoidal disease in 16.8% and fissures in 6%. Six patients developed Kaposi's sarcoma and seven, non-Hodgkin's lymphoma. No anal cancers were observed. Finally, wound healing was slowed in the patients operated on for haemorrhoids, fissures and suppuration. No statistical analysis could be performed because of the small number of patients.

Adult↗
PubMed1991

Kaposi's sarcoma of the colon in a young HIV-negative woman with Crohn's disease.

We report a case of isolated colonic Kaposi's sarcoma in a 36-year-old HIV-negative woman with refractory Crohn's disease of the colon and perineum following 11 months' treatment with azathioprine. The clinical features of this case are quite different from those classically described in Kaposi's sarcoma. Among the known risk factors, iatrogenic immunosuppression would appear to be the most probable.

Adult↗
PubMed1990

Rectal stenosis due to Veganine suppositories.

A new case of rectal stenosis due to the chronic use of suppositories of associated analgesic drugs is reported. Surgical treatment was conservative. This observation outlines the dramatic consequences of chronic self-treatment and the difficulties of ensuring long-term withdrawal.

Acetaminophen↗
PubMed1990

Anal ulcerations due to cytomegalovirus in patients with AIDS. Report of six cases.

Lesions due to cytomegalovirus (CMV) are frequent in the immunocompromised patient. This is particularly the case in patients with AIDS, where the colon and rectum are the regions most often involved. The authors report six cases of anal ulcerations due to CMV in patients with AIDS. These lesions, confirmed histologically, were either isolated or associated with other localizations. Treatment is based on specific antiviral agents but resistance and recurrence can occur. The current report underlines the importance of histologic examination of anal lesions in HIV-infected subjects.

Acquired Immunodeficiency Syndrome↗
PubMed1985

[Anal fistulas].

Explore the source record for details and available documents.

Abscess↗
PubMed1983

[Intramural abscesses of the rectum].

Intramural abscesses of the rectum developed in the complex longitudinal layer may be isolated or associated with a transphincteric fistula. They may be acute or subacute and are diagnosed by intrarectal palpation. The only treatment is surgical: the abscess is opened into the rectal cavity, except in case of association with suprasphincteric fistula, when it must be drained through the skin. Postoperative complications are minor ones and relapses are rare (1.75% of cases).

Abscess↗
PubMedDate not supplied

Hemorrhoidectomy: Hospital Leopold Bellan procedure.

The authors describe their hemorrhoidectomy technique, a modification of Milligan-Morgan. It differs by the association of a posterior anoplasty (with internal sphincterotomy in the case of a fissure or sphincter hypertonia) and of a sub-mucocutaneous dissection of the security bridges. They report on their experience with 410 operations carried out during the year 1985. Immediate complications are mainly hemorrhage (2.68%) and urinary problems (9%). Average cicatrization time is about six weeks. At one year, there were no relapses nor fissures. A moderate stenosis was observed in 1.45% of the cases, and a hypocontinence to flatus in 2.3%. Use of a CO2 laser does not result in any modification of these results.

Fissure in Ano↗