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Transperineal Repair Of Primary Obstetric Rectovaginal Fistulas PubMed articles on BioPortfolio. Our PubMed references draw on over 21 million records from the medical literature. Here you can see the latest Transperineal Repair Of Primary Obstetric Rectovaginal Fistulas articles that have been published worldwide.
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Rectovaginal fistulas are notorious for both their morbidity and their difficulty to treat effectively. A variety of methods for repair has been described; however, there is no consensus on the ideal repair. A better understanding of the anatomical relationship of fistulas to the anal sphincter and detrusor muscles is one of the components necessary to develop an effective treatment plan for repair and preservation of sphincter mechanics.
I repaired iatrogenic recto-urethral fistulas (RUF) in 6 patients. All the fistulas had developed after surgery, 5 for prostate cancer (prostatectomy) and the remaining one for pelvic solitary fibrous tumor. All of them were"simple"fistulas. I performed repair using the transperineal approach with gracilis muscle flap interposition in 4 cases, and using the transsphincteric approach (modified York-Mason method) in 2, with the cooperation of general surgeons and/or plastic surgeons. All fistulas were success...
Crohn's rectovaginal fistulizing disease remains notoriously difficult to treat. A phase I clinical trial to evaluate the safety and feasibility of a novel protocol using a mesenchymal stem cell (MSC)-coated Gore Bio-A fistula plug for the treatment of medically and surgically refractory Crohn's rectovaginal fistulas was conducted.
Rectovaginal, pouch-vaginal, and recto-urethral fistulas are very challenging to treat. Gracilis muscle interposition was shown be an effective treatment for these complex fistulas. The aim of this study was to investigate the feasibility and outcomes of redo gracilis interposition for persistent and recurrent complex perineal fistulas.
To describe and compare baseline renal anatomy and renal function in patients with obstetric fistulas, and to evaluate whether pre-operative renal testing and imaging may aid with operative decision making.
Rectovaginal fistula caused by a tension-free vaginal mesh (TVM) is a rare condition. Moreover, a rectovaginal fistula is a challenging issue to address for surgeons regardless of causes. Due to a low rate of occurrence, treatment modality for a rectovaginal fistula caused by a TVM has previously received little attention. A successful surgery using several key techniques to address a rectovaginal fistula caused by a TVM is herein reported. A 78-year-old woman who underwent a TVM for a rectocele three month...
The case of a 34 year old lady with a rectovaginal fistula following instrumental vaginal delivery is described in this video. On examination, there was a 2 cm diameter defect just above the anal sphincter. Endoanal ultrasound showed a less than one quadrant full thickness scarring of the external and internal anal sphincter.
The referral system plays a crucial role in antenatal care and childbearing by providing access to emergency obstetric care. Excess referral from primary care and bypassing secondary levels of care leads to overcrowding of high risk and normal mothers in tertiary centers. Hence, this study aims to assess the gaps in the referral of patients with obstetric emergency from primary care to tertiary care.
Our aim was to explore the association between anal incontinence (AI) and persistent anal sphincter defects diagnosed with 3D endoanal (EAUS), introital (IUS) and transperineal ultrasound (TPUS) in women after obstetric anal sphincter injury (OASI) and study the association between sphincter defects and anal pressure.
Obstetric anal sphincter injuries represent the minority of obstetric lacerations, but can have a significant long-term impact on urinary and fecal continence, as well as pelvic organ support. Accurate diagnosis of lacerations, appropriate repair, and close follow-up are essential to healthy healing and to improve outcomes for women. The infrequency of these injuries has resulted in a lack of familiarity with laceration repair and postpartum care of this population at all levels of practice. As such, contin...
To evaluate the mode of delivery and stillbirth rates over time among women with obstetric fistula DESIGN: Retrospective record review SETTING: Tanzania, Uganda, Kenya, Malawi, Rwanda, Somalia, South Sudan, Zambia, and Ethiopia POPULATION: 4,396 women presenting with obstetric fistulas for repair who delivered previously in facilities between 1990-2014 METHODS: Retrospective review of trends and associations between mode of delivery and stillbirth, focusing on Caesarean section (CS), assisted vaginal delive...
Comparing prenatal and postnatal surgical repair techniques for myelomeningocele (MMC), in utero fetal surgery has increasingly gained acceptance and is considered by many specialized centers the first choice of treatment. Despite its benefits, as demonstrated in the Management of Myelomeningocele Study (MOMS), including reduced need for CSF shunting in neonates and improved motor outcomes at 30 months, there is still an ongoing debate on fetal and maternal risks associated with the procedure. Prenatal open...
There are conflicting views regarding techniques for repair of small umbilical hernias (UHs). Here, we compare the recurrence rate in primary repair with that reported for mesh repair by examining a single surgeon's practice at a large medical center with a comprehensive electronic medical record. A six-year retrospective review of primary UH repairs between January 2012 and December 2017 at Kaiser Permanente Los Angeles Medical Center was undertaken. Patients were identified through a database search of th...
To explore a series of classic bladder exstrophy (CBE) cases referred to the authors' institution where primary closure with penile disassembly epispadias repair was complicated by penile injury. The penile disassembly technique is frequently combined with bladder closure in patients with CBE undergoing the complete primary repair of exstrophy (CPRE). Penile disassembly has been posited as a risk for penile injury by ischemic mechanisms.
To compare clinical features, laboratory data and fetal-maternal outcomes between 1000 women with obstetric APS (OAPS) and 640 with aPL-related obstetric complications not fulfilling Sydney criteria (non-criteria OAPS, NC-OAPS).
Injury to the posterior cruciate ligament (PCL) is most commonly seen in the setting of a multiligamentous injured knee, and isolated PCL tears are rare. PCL injuries are generally treated either conservatively or by PCL reconstruction using a graft. If a proximal or distal tear is present, the injured ligament can also be treated by primary repair, in which the ligament is reattached to the tibial or femoral insertion. This has the (theoretical) advantages of preserving the native tissue, maintaining propr...
Dural arteriovenous fistulas of the craniocervical junction are rare but the most dangerous of spinal fistulas. The concurrent brainstem edema has been attributed to increased pressure within the venous outflow of the brainstem and upper cord, but the differential diagnosis of brainstem edema is demanding. This report presents the details of clinical findings, magnetic resonance imaging (MRI) , surgical techniques, and follow-up of these fistulas.
Hemorrhoids, anal fissures, and fistulas are common benign anorectal diseases that have a significant impact on patients' lives. They are primarily encountered by primary care providers, including internists, gastroenterologists, pediatricians, gynecologists, and emergency care providers. Most complex anorectal disease cases are referred to colorectal surgeons. Knowledge of these disease processes is essential for proper treatment and follow up. Hemorrhoids and fissures frequently benefit from non-operative...
Techniques for endovascular management of carotid-cavernous fistulas (CCF) have evolved over the years. Current strategies include transarterial or transvenous approaches, and direct puncture or exposure of the cavernous sinus (CS). Rarely, complex fistulas may require multiple approaches or procedures. We describe our experience managing these lesions, reporting on outcomes and technical nuances.
The concern about DNA damage has directed efforts toward evaluating the genotoxic potential of physical and chemical agents. Since the extent of DNA damage is also related to the capacity of the organism in repairing the DNA, the advance of toxicological studies on this area depends on the characterization of the DNA repair mechanisms in the available models. The cellular zebrafish models, for example, replace mammalian cells to answer ecologically relevant questions on aquatic toxicology. So, the aim of th...
The incidence of postoperative fistula following primary cleft palate repair ranges from 0% to 58%. The reported recurrence rate is between 33% and 37%, and the prognosis of a successful closure declines with each reoperation. Closure of palatal fistulas can be achieved by different techniques depending on its size and the experience of the surgeon. Local, regional and distant flaps are commonly used. Alternatively, or in addition to the previous ones, synthetic materials are becoming very popular nowadays....
To identify factors influencing the long-term prognosis after surgical repair of obstetric fistula, establish a prognosis-based classification system, and examine changes in quality of life after surgery.
Primary closure is often inadequate for large congenital diaphragmatic hernia (CDH) and necessitates repair by prosthetic patch or autologous muscle flap. Our aim was to evaluate outcomes of open patch versus flap repair, specifically diaphragmatic reherniation.
Differences between the features of primary cancer and matched metastatic cancer have recently drawn attention in research. This study investigated the concordance in microsatellite instability (MSI) and mismatch repair (MMR) status between primary and corresponding metastatic colorectal cancer (CRC).
Abdomino-perineal resection (APR) for rectal cancer is challenging, due to the difficult exposure of the surgical field. Many investigations proved worst results in terms of circumferential resection margin (CRM) involvement compared to rectal anterior resection (RAR) with total mesorectal excision (TME). Extralevator abdomino-perineal excision (ELAPE) improved oncologic outcomes, but is burdened by important limitations (positioning, wound closure). Applying the concept of transanal minimally invasive surg...