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Results for “RECTAL PROLAPSE”

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At least 1,639 records · Page 91Linked to original sources
PubMed1994

Mucosal prolapse syndrome: diagnosis with endoscopic US.

PURPOSE: To determine the value of endoscopic ultrasound (US) in the diagnosis of mucosal prolapse syndrome (MPS), also known as solitary ulcer of the rectum. MATERIALS AND METHODS: Three male and two female patients (age range, 17-66 years) with biopsy-proved MPS underwent endoscopic US. The average rectal wall thicknesses of the affected areas were compared with those of normal-appearing mucosa. RESULTS: The gross appearance of the rectal lesions was classified into three types: polypoid (n = 2), flat (n = 1), and ulcerative (n = 2). In all three types of lesions, endoscopic US demonstrated smooth, diffuse thickening of the third layer of the rectal wall; the other layers had minimal thickening. Neither a solid hypoechoic mass nor a transmural infiltrating lesion was visible, and the five-layer structure of the rectal wall was completely preserved. In the polypoid lesions, the third layer was winding as well as thickened, and microcystic components were occasionally found. CONCLUSION: Endoscopic US enabled differentiation of MPS from other conditions such as malignant neoplasia and Crohn disease.

Adult↗
PubMed1977

[Mathematical-physical deliberations over the development of artificial-anus prolapse (and the therefrom derived attachment technic for the artificial anus)].

It is established that most colostomies which lead to prolapse because of imperfect operative technique are shaped like a truncated cone. Mathematical-physical considerations show mechanisms which in such cases can produce prolapse of the colostomy. Considering these criteria and recent clinical experience, a suitable colostomy is described.

Colostomy↗
PubMed1987

[Treatment of genital prolapse via abdominal approach and using prosthetic material. Analysis of a series of 40 cases].

From a series of 40 cases and with a 2 to 8 years follow-up, the authors have analyzed the results of the surgical treatment via abdominal approach and with the use of prosthetic material, of severe genital prolapses. A stress urinary incontinence was associated in 77.5% of the cases. Post-operative complications and recurrences are few. As far as urinary incontinence is concerned, the true corrected failure rate is close to 10% and an urodynamic exploration prior to surgery is mandatory. The main indications of this type of surgery are defined especially in case of recurring prolapse or a previous history of hysterectomy.

Bioprosthesis↗
PubMed2004

[Study of morphological changes in levator ani muscle of patients with stress urinary incontinence or pelvic organ prolapse].

OBJECTIVE: To investigate the morphological characteristics of levator ani muscle in patients with stress urinary incontinence (SUI) or pelvic organ prolapse (POP) and to explore whether the alterations could contribute to pathogenesis of the diseases. METHODS: Biopsy specimens of levator ani muscle were obtained from 15 patients with SUI, 19 patients with POP and 3 asymptomatic controls with rectal cancer during operation. The structure of levator ani muscle was examined with routine histological techniques: HE staining, modified Gomori trichrome staining, NSE staining, ACP staining, and adenosine triphosphatase (ATPase) staining. RESULTS: There was no significant difference in age, parity, menopausal time, disease severity and leak point pressure between SUI patients with or without muscle fibers (P > 0.05). The muscular fiber density of levator ani muscles in SUI and POP groups was decreased, fibers were arranged in disorder and separated by large quantities of dense connective tissues with infiltrating inflammatory cells. The muscle fiber fascicles showed obvious grouped denervative atrophy, fiber type grouping and angular in shape. And also there was myopathic degeneration such as centrally located nuclei, peripheral phagocytosis and vacuolated necrosis. CONCLUSIONS: There are both neurogenic and myopathic alterations in levator ani muscle's structure in patients with SUI and POP. The presence of both acute and chronic abnormalities indicates that the weakness of pelvic floor is a consequence of prolonged denervation.

Aged↗
PubMed1977

Hemorrhoidectomy--how I do it: experience with the St. Mark's Hospital technique for emergency hemorrhoidectomy.

Eighty-five patients who had thrombosed hemorrhoids underwent emergency hemorrhoidectomy according to St. Mark's Hospital technique, with very good results. All specimens were found to have dilated blood vessels filled with thrombi of different sizes, with irregular, fibrotic or hyalinized vascular walls. Early complications included urinary retention and painful defecation in some patients. Late complications included only skin tags. No sepsis was found among our patients. Although operative bleeding can be tedious during the hemorrhoidectomy, it was a complication in the postoperative period of only one patient. Segmental, open hemorrhoidectomy performed according to the St. Mark's Hospital technique has been shown to be an ideal operation for the treatment of patients who have hemorrhoidal thrombosis, prolapse, edema, and bleeding.

Adult↗
PubMed2001

[The Longo and Milligan-Morgan hemorrhoidectomy. A prospective comparative study of 300 patients].

INTRODUCTION: Stapled haemorrhoidectomy according to Longo for treating reducible anal and mucosal prolapse appears to be very simple technically. In order to investigate the feasibility and to delineate the value of this procedure it was compared to standard open haemorrhoidectomy according to Milligan-Morgan in a prospective study. METHOD: In 1998 and 1999, 300 patients with third-degree haemorrhoids were operated on either with a Milligan-Morgan or a Longo technique. Intraoperative and postoperative performance--complications, length of surgery, consumption of analgetics, hospital stay, return to work--were evaluated. Follow-up was 1, 3 and 6 months. RESULTS: Length of surgery for both types of operation was the same. In comparison with the conventional open excision, patients with a stapled haemorrhoidectomy required considerably less analgetics. Hospital stay was shorter and return to work quicker and there were fewer morphological residues, e.g. skin tags. However, the costs of the procedure were considerably higher because of the disposable instrument. CONCLUSION: This new surgical procedure of supra-anodermal resection according to Longo offers advantages in the repair of prolapsing haemorrhoidal disease. Despite its primary simplicity, in our opinion the surgeon has to have colorectal, especially proctologic, experience. Although costs are significantly higher, this procedure might replace conventional techniques in many cases with prolapsing haemorrhoids.

Adult↗
PubMed2001

Pelvic floor imaging.

A greater awareness of the therapies now available for pelvic floor dysfunction has increased demand for specialized imaging of this region. Some of the techniques required are available at relatively few centers, and the purpose of this review is to introduce the emerging subspecialty of pelvic floor imaging to a more general readership. Pelvic floor anatomy is complex and is being unraveled by means of magnetic resonance (MR) imaging. This is discussed in detail by using a global, rather than a compartmentalized, anatomic approach. The physiology of normal urinary and anal function and the routine clinical tests applied to them are outlined. The imaging techniques involved include MR imaging, endosonography, and fluoroscopy. The main investigations include video urodynamic imaging, evacuation proctography, dynamic cystoproctography, dynamic MR imaging of the pelvic floor, and endoluminal imaging of the anal sphincters with MR imaging and ultrasonography. These are described in detail, and their role with regard to the main pathologic conditions of the pelvic floor--urinary and anal incontinence, constipation, and prolapse--are discussed.

Anal Canal↗
PubMed2006

[Efficacy and safety of Pelvicol in the vaginal treatment of prolapse].

OBJECTIVES: To evaluate the efficacy and safety of a porcine biomaterial (Pelvicol) in the transvaginal surgical treatment of urogenital prolapse. MATERIAL AND METHOD: Prospective study from June 2001 to February 2004 based on 132 patients with a mean age of 67.6 +/- 9.89 years presenting major urogenital prolapse: 132 cystoceles and 84 rectoceles with 100% and 63.4% of grade 2 or 3, respectively. Patients were evaluated by questionnaire and clinical examination at 1 month, 6 months, 12 months and 24 months after the operation. Two hundred and sixteen Pelvicol implants were inserted via a vaginal approach: 132 anterior implants and 84 posterior implants. RESULTS: The mean follow-up was 21 months [range: 6-24]. No intraoperative complication was observed. The postoperative complication rate was 11.3% (15/132) including 1 prosthetic exposure with a favourable outcome. After 6 months, 1 recurrence of cystoceles and 1 recurrence of rectoceles were found in 132 patients. Out of the 117 patients followed up for 12 months, 6 presented with grade 2 cystoceles and 1 grade 2 rectoceles. After 24 months, out of the 107 patients evaluated, 18 cystoceles and 9 rectoceles of grade 2 or 3 were found. Globally, 83.1% of patients did not present with grade 2 or 3 recurrences after 24 months. Safety was considered to be good with 10% of moderate pelvic pain and 6% of de novo dyspareunia at 12 months. The overall satisfaction rate was 94%. CONCLUSION: These preliminary results demonstrate an efficacy of 83.1% at 24 months and the good safety of Pelvicol in the transvaginal surgical treatment of urogenital prolapse.

Aged↗