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At least 19 recordsLinked to original sources
PubMed2001

Dynamic magnetic resonance imaging defecography: a diagnostic alternative in the assessment of pelvic floor disorders in proctology.

PURPOSE: Standard diagnostic proctologic procedures in the assessment of pelvic floor disorders include clinical evaluation and endoscopy. Particular aspects of combined pelvic floor disorders, especially those involving more than one pelvic compartment, may remain undetected without additional technical diagnostic procedures such as videoproctoscopy, cinedefecography, or colpocystodefecography. The aim of the study was to review the potentials of dynamic magnetic resonance imaging defecography to elucidate the underlying anatomic and pathophysiologic background of pelvic floor disorders in proctologic patients. PATIENTS AND METHODS: Dynamic magnetic resonance imaging defecography was performed in 20 Patients (13 females) with main diagnoses such as rectal prolapse or intussusception, rectocele, descending perineum, fecal incontinence, outlet obstruction, and dyskinetic puborectalis muscle after clinical evaluation. The investigation was performed on a 1.5 T-magnetic resonance imaging machine in supine position. The rectum was filled with Gd-DTPA enriched ultrasound gel. First a T1/T2 weighted investigation of the pelvis was performed, followed by defecography with evacuation of the rectum. Images were obtained in a sagittal plane in a frequency of 1 image/second (true FISP) at rest and during straining. The obtained magnetic resonance imaging video tapes were analyzed off-line with cinematographic evaluation of bladder base, uterus, and anal canal position in relation to the pubococcygeal line by a blinded radiologist. Investigation time was 20 minutes. RESULTS: In dynamic magnetic resonance imaging defecography of the pelvic floor, 12 patients with descending perineum, 10 rectoceles (10 females), 6 cystoceles (6 females), 4 enteroceles (4 females), 8 intussusceptions (5 females), and a dyskinetic puborectalis muscle in 3 males were detected. In 11 females and 3 males multifocal disorders were found, involving more than one compartment in females, whereas in males complex defects were restricted to the posterior compartment. Magnetic resonance imaging defecography revealed diagnoses consistent with clinical results in 77.3 percent and defects in addition to clinical diagnoses in combined pelvic floor disorders in 34 percent. CONCLUSIONS: In complex pelvic floor disorders, involving more than a single defect, dynamic magnetic resonance imaging represents a convenient diagnostic procedure in females and to a lesser extent in males, in particular in terms of dynamic imaging of pelvic floor organs during defecation. In addition to the clinical assessment, dynamic magnetic resonance imaging had clinical impact in proctologic and interdisciplinary treatment.

Adult↗
PubMed1994

[Caudal anesthesia in proctological surgery].

The technique and advantages of caudal peridural anesthesia for proctology surgery are reported. The scarce invasivity of this methodology, the scarce or lack of interference with respiratory and cardiocirculatory functionality, the good analgesic effect postoperatively in our patients operated for proctology pathology, established the reason why we consider caudal analgesia particularly indicated for proctology surgery.

Anesthesia, Caudal↗
PubMed1985

The mycotic flora in proctological patients with and without pruritus ani.

The perianal mycotic flora was studied in proctological patients with and without pruritus ani, as well as in control subjects. Four groups of patients underwent perianal mycoculture. In Group 1, 53 patients with anal pruritus were treated for benign anorectal disease. In Group 2, 24 patients with no underlying disease presented with anal pruritus. Both of these groups underwent concomitant chemical and parasitical examination of the faeces and an oral glucose tolerance test. In Group 3, 50 patients without pruritus ani at present or in the past were treated for benign anorectal diseases. In Group 4, 47 surgical patients without pruritus ani were treated for benign (9) and malignant (38) non-proctological diseases. In Group 1 the mycoculture was positive in 24/53 patients (Candida albicans 14, dermatophytes 10). In Group 2 fungal infections were seen in 16/24 patients (C. albicans 7, dermatophytes 9). No parasites or diabetes were found in either group. In Group 3 C. albicans was isolated in 14/50 patients. In Group 4 C. albicans was found in 11/47 cases (2 in benign, 9 in malignant diseases). Infection by C. albicans was observed in all groups studied, independent of the presence of disease or anal pruritus. The presence of dermatophytes was always associated with pruritus ani.

Adolescent↗
PubMed1992

Can proctological procedures resolve perianal pruritus and mycosis? A prospective study of 23 cases.

Twenty-three patients with pruritus ani associated with anal mycosis underwent primary treatment of a concurrent anal disorder. The anal disorders included haemorrhoids (n = 9), fissure (n = 8), anal spasm without fissure (n = 5), and occult mucosal prolapse (n = 1). Pretreatment investigation of faeces for parasites was negative. The glucosal tolerance test and white blood cell count were normal in all cases. Culture of skin smears from the perianal region was positive for Candida only in 16 patients, Dermatophytes only in 6 and a combination of both in 1 patient. Following the appropriate proctological procedure, pruritus resolved or markedly improved in 20 patients. The remaining three patients required antifungal treatment with econazole. Two of these, however, continued to complain of pruritus. It is suggested that in patients with pruritus ani associated with perianal mycosis, antimycotic therapy should be used only if fungal infection persists after treatment of the underlying proctological disease.

Adolescent↗
PubMed1999

[Experiences in surgery of proctologic diseases in patients with HIV infection].

Individuals who are seropositive for the human immunodeficiency virus (HIV) often suffer from disorders affecting the anorectum, but unfortunately the best kind of treatment frequently seems questionable. In a retrospective investigation we reviewed 29 HIV-positive patients with anorectal lesions who had experienced a proctologic operation. Our impression correlates with other findings according to which HIV-positive patients in advanced stages have a poorer post-operative outcome in terms of morbidity and survival than patients in an early CDC disease stage. This implies that the indication for a proctologic operation in an immunocompromised state has to be considered carefully.

AIDS-Related Opportunistic Infections↗
PubMed2002

New approaches in ambulatory proctology.

Ambulatory proctology is till now very underestimated discipline, which is out of interest of big surgeons. But is is a very important field due to incidence of proctological affections and severe social consequences of their inappropriate diagnosis and treatment. We stress the conservative and semi-invasive treatment of hemorrhoids, anal thrombosis and anal fissures. We also mention the other anal pathologies.

Fissure in Ano↗
PubMed1976

[Multicenter clinical study of a novel steroid-free preparation in proctology].

In a multicentre study 15 physicians investigated the therapeutic efficacy and tolerance of Faktu suppositories and ointment (containing the active principle of Albothyl, a condensation product of m-cresolsulfonic acid and formaldehyde) in 585 patients with proctological affections. Highly satisfactory results were achieved in 486 patients (83.1%). The following were found to be the main indications: -treatment of wounds after proctological operations, -fresh and fissures, -bleeding internal haemorrhoids, -anal eczema and anal pruritus, -rhagades and perforated or prolapsed external haemorrhoids (perianal thrombosis). None of the investigators reported any persisting adverse side-effects. 16% of the patients complained of local discomfort of varying intensity such as pruritus, burning or irritation. The symptoms mostly appeared on commencement of the treatment and necessitated discontinuation of therapy in 5.3% only. The extremely favourable effect of Albothyl - the active principle of Faktu - is due to its unique mechanism of action: the markedly acid milieu of the substance. Furthermore the Faktu preparations do not contain any steroids and consequently they can be used without any misgivings over prolonged periods.

Adolescent↗
PubMed1990

[The past and future of proctology].

Since antiquity, surgical treatments of anorectal lesions were performed by barbers and surgeons; proctology became with time a surgical speciality well defined and recognized todays. History of proctology is illustrated by some important figures and events: St. Fiacre, Felix the surgeon who operated on King Louis XIV's fistula and the acutely thrombosed hemorrhoidal prolapse of Napoleon.

Colorectal Surgery↗
PubMedDate not supplied

Treatment of haemorrhoids at the Moscow Research Institute of Proctology.

The article sums up experience acquired with the treatment of more than 4,000 patients with haemorrhoids at the Research Institute of Proctology (Moscow). The pattern that emerges is that only about 30% of patients with haemorrhoids should be subjected to radical haemorrhoidectomy. Others can be cured on conservative lines, including sclerosing injections. Two modifications of haemorrhoidectomy are described which have been developed at the Research Institute of Proctology (Moscow). Long-term results of haemorrhoidectomy have been examined in nearly 1,500 patients. In the post-operative period of five and more years, 3.78% of patients had recurrences.

Administration, Rectal↗