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Annals of the Royal College of Surgeons... Feb 2021Aggressive angiomyxoma is a rare mesenchymal tumour, primarily arising in the soft tissue of the pelvis and perineum in women of reproductive age. There is a paucity of... (Review)
Review
Aggressive angiomyxoma is a rare mesenchymal tumour, primarily arising in the soft tissue of the pelvis and perineum in women of reproductive age. There is a paucity of evidence on optimal management because of the rarity of these tumours, but the consensus has been for surgical excision. We present the case of a 65-year-old woman who was admitted with left-sided buttock pain and initially diagnosed with a perianal abscess. She underwent examination under anaesthesia rectum with surgical excision of the lesion, subsequent histopathological and immunochemical analysis was suggestive of aggressive angiomyxoma. To complement our case report, we also present a literature review focusing on aggressive angiomyxoma in the ischioanal fossa (also known as the ischiorectal fossa) with only eight cases of primary aggressive angiomyxoma involving the ischioanal fossa documented to date. The primary aims of this case report and literature review are to familiarise clinicians with the clinical, histopathological and immunochemical features of these tumours, and to increase appreciation that despite the rarity of aggressive angiomyxoma, it might be considered in the differential diagnosis of ischioanal lesions.
Topics: Abscess; Aged; Anus Diseases; Diagnostic Errors; Digital Rectal Examination; Female; Humans; Magnetic Resonance Imaging; Myxoma; Neoplasm, Residual; Perineum; Postmenopause; Treatment Outcome
PubMed: 33559550
DOI: 10.1308/rcsann.2020.7008 -
The Journal of Reproductive Medicine 2015To determine the applicability of dorsal perineal membrane (DPM) and urethrovaginal sphincter muscle (UVSM) site-specific defect reconstructions. The secondary objective... (Observational Study)
Observational Study
OBJECTIVE
To determine the applicability of dorsal perineal membrane (DPM) and urethrovaginal sphincter muscle (UVSM) site-specific defect reconstructions. The secondary objective was to establish how these reconstructions affect women's physical, emotional, and social well-being.
STUDY DESIGN
An observational cohort study was conducted for 24 months on 3 patients. Clinical examinations with pelvic organ prolapse quantification panel, validated instruments of the Pain Numeric Scale, the Modified Body Image Scale (M-BIS), and the Female Sexual Function Index (FSFI) were applied preoperatively and 6 months postoperatively.
RESULTS
Intraoperatively the DPM and the UVSM site-specific defects were identified and their reconstructions were performed without surgical complications. Postoperatively, symptoms have subsided, perineal body and genital hiatus returned to expected limits, FSFI increased, and M-BIS improved.
CONCLUSION
In this study group, modified posterior perineoplasty was applied with ease and the operation alleviated physical, emotional, and social symptoms associated with posterior perineum defects.
Topics: Adult; Cohort Studies; Dyspareunia; Esthetics; Female; Gynecologic Surgical Procedures; Humans; Muscle, Skeletal; Pain Measurement; Patient Satisfaction; Pelvic Organ Prolapse; Perineum
PubMed: 25898473
DOI: No ID Found -
Gaceta Sanitaria 2021This research aims to determine the influence of Web-based learning media on improving perineum rupture stitching skills for D-III Midwifery students.
OBJECTIVE
This research aims to determine the influence of Web-based learning media on improving perineum rupture stitching skills for D-III Midwifery students.
METHOD
This study uses a Research and Development (R&D) research design with the Borg & Gall development model to test the use of this product. The Quasi-Experimental research with a non-equivalent control group design was conducted in January-February 2020 at AKBID Pelamonia Makassar. The sample in this study was the second semester of the Midwifery Academy Pelamonia VII Wirabuana Makassar, totaling 64 people who were divided into two groups of intervention and control. The intervention group I (WEB media giving) amounted to 32 people and control 32 people. The sampling technique used is purposive sampling. At the end of the meeting, a post-test was conducted. The statistical test used was the paired sample t-test and Wilcoxon test.
RESULTS
The percentage of application assessment using the Technology Acceptance Model (TAM) questionnaire to assess the application's usability level is a very good category and can be interpreted that students accept WEB-based learning media. Statistical tests showed differences in the results of measurement I and measurement II in the removal of grade II perineum rupture in the control group (p<0.05) and contributed 15.6%. In the intervention group I (WEB-based learning media), there were differences in skills before and after media giving (p<0.05) and contributed 89.8% in improving the skills of the second semester Midwifery DIII students regarding the sewing of second-degree perineum rupture.
CONCLUSION
The use of Web-Based Learning Media facilitates and enhances students in performing second-degree perineum rupture sewing skills.
Topics: Female; Humans; Internet; Learning; Midwifery; Perineum; Pregnancy; Students; Students, Nursing
PubMed: 34929823
DOI: 10.1016/j.gaceta.2021.07.017 -
Midwifery Sep 2022Injury to the perineum is a common sequalae of vaginal birth. Lack of appropriateperineal wound care in the postnatal period is associated with increased pain and... (Review)
Review
BACKGROUND
Injury to the perineum is a common sequalae of vaginal birth. Lack of appropriateperineal wound care in the postnatal period is associated with increased pain and morbidity in theshort, medium, and long term. Women and maternity healthcare providers require high-levelevidence-based information to inform postnatal perineal wound care.
OBJECTIVES
To review the high-level evidence informing postpartum management of perineal trauma.
DESIGN
A systematic search of the literature regarding the postnatal management of perineal injury to produce a critical narrative review of the available level I evidence regarding the postnatal management of perineal trauma up to six months postpartum was undertaken. Systematic reviews were identified from searching the following databases: CINAHL, Cochrane Library, MEDLINE, PUBMED, and SCOPUS. Papers were selected if they met the following criteria: systematic reviews/level I evidence related to postnatal management of any form of perineal injury up to six months post birth, written in English, and published from January 2010 to 30 May 2021. A synthesis of the results was developed.
FINDINGS
Nineteen systematic reviews met criteria for inclusion. The systematic reviews fell into one of the following categories of perineal trauma management: use of medication for pain relief, the decision to suture, suture techniques/materials, cryotherapy, use of antibiotics, ultrasound, physiotherapy treatment and complementary therapies.
CONCLUSION
There is an overall lack of focused high-quality research to inform management of perineal injuries beyond the acute postnatal period. Clinical trials that include women's satisfaction and wellbeing as outcome measures are limited.
IMPLICATIONS FOR PRACTICE
It is vital that women are provided with evidence-based postnatal care strategies to enhance perineal healing and resumption of normal activities. Future clinical trials for the management of perineal trauma should incorporate women's satisfaction as an outcome measure.Further research examining the follow-up care for the medium-long term for women experiencing ongoing sequalae of symptoms in the community setting is required to support clinical practice recommendations.
Topics: Female; Humans; Pain; Pain Management; Parturition; Perineum; Postpartum Period; Pregnancy
PubMed: 35792304
DOI: 10.1016/j.midw.2022.103410 -
Prostate Cancer and Prostatic Diseases Sep 2021Rrisk of infection and hospitalization after transrectal prostate biopsy (TRBx) has been increasing worldwide. Several modified antibiotic regimens have met with... (Review)
Review
BACKGROUND
Rrisk of infection and hospitalization after transrectal prostate biopsy (TRBx) has been increasing worldwide. Several modified antibiotic regimens have met with variable success in preventing such infections. Transperineal prostate biopsy (TPBx) is increasingly recommended as the preferred alternative due to a potentially lower risk of post-biopsy infections. Aim of this review is to define the magnitude of post-biopsy complications and the effectiveness of preventive strategies, including TPBx approach.
METHODS
We performed a focused review of literature on infectious complications after TRBx and detailed the use of various preventive measures. We summarized the effectiveness of several preventive measures, including TPBx, and outlined the inconsistencies in reported outcomes. We identified potential barriers to the uptake of TPBx, including the gap in knowledge such as lack of high-quality evidence.
RESULTS
Several antibiotic prophylaxis protocols, including targeted and augmented, have been utilized for TRBx without demonstrating a clearly superior regimen. Of the non-antibiotic preventive measure, povidone-iodine rectal prep appears to be most effective strategy. Several single-arm cohort studies have reported very low rates of infections after TPBx and demonstrated the feasibility of an office-based procedure. However, barriers to the adoption of TPBx exist including retrospective data, and conflicting results showing minimal reduction in complications with increased burden of resource utilization. Presently, there are no randomized studies comparing the infectious complications after TRBx and TPBx. We discuss the rationale and protocol for a randomized controlled trial to determine the comparative effectiveness of biopsy techniques.
CONCLUSIONS
TPBx approach has the potential to lower the rate of post-biopsy infections and hospitalizations. However, there are several barriers to widespread adoption of this approach including inconsistencies in reported outcomes and lack of Level-1 evidence. Randomized controlled studies are required to directly compare the infectious complications associated with each biopsy procedure.
Topics: Biopsy; Communicable Diseases; Humans; Male; Perineum; Postoperative Complications; Prognosis; Prostatic Neoplasms; Randomized Controlled Trials as Topic; Rectum
PubMed: 33767354
DOI: 10.1038/s41391-021-00352-1 -
The Journal of Urology Apr 2015The bulbospongiosus muscle is part of the superficial muscular layer of the perineum and pelvic floor. Its morphology remains controversial in the literature. Therefore,...
PURPOSE
The bulbospongiosus muscle is part of the superficial muscular layer of the perineum and pelvic floor. Its morphology remains controversial in the literature. Therefore, we reinvestigated the fascial arrangement and fiber courses of the bulbospongiosus muscle and its topographical relation to the external anal sphincter.
MATERIALS AND METHODS
The perineum was dissected in 9 male cadavers (mean ± SD age 78.3 ± 10.7 years). Select samples were obtained for histology and immunohistochemistry. In 43 patients (mean age 60.7 ± 12 years) the topographical relation between the bulbospongiosus muscle and the external anal sphincter was determined by magnetic resonance imaging.
RESULTS
The perineum contains several fascial layers consisting of elastic and collagen fibers as well as bundles of smooth muscle cells. The bulbospongiosus muscle was subdivided into a ventral and dorsal portion, which developed in 4 variants. The ventral insertion formed a morphological unity with the ischiocavernous muscle while the dorsal origin had a variable relation to the external anal sphincter (5 variants). A muscle-like or connective tissue-like connection was frequently present between the muscles. However, in some cases the muscles were completely separated.
CONCLUSIONS
We suggest a concept of variations of bulbospongiosus muscle morphology that unifies the conflicting literature. Its ventral fiber group and the ischiocavernosus muscle form a functional and morphological unity. While the bulbospongiosus muscle and the external anal sphincter remain independent muscles, their frequent connection might have clinical implications for perineal surgery and anogenital disorders.
Topics: Aged; Aged, 80 and over; Anal Canal; Cadaver; Humans; Male; Muscle, Skeletal; Pelvic Floor; Perineum
PubMed: 25444962
DOI: 10.1016/j.juro.2014.10.050 -
Andrologia Dec 2019It was known that in animals, anogenital distance (AGD), an indicator of prenatal androgen environment, was a stabile phenotype that persists throughout life. However,...
It was known that in animals, anogenital distance (AGD), an indicator of prenatal androgen environment, was a stabile phenotype that persists throughout life. However, it is not known whether this applies to humans. In this study, we aimed to investigate whether anogenital distance is stable or not in males. We evaluated a total of 130 men targeted for group 1 (fathers) and group 2 (sons) in each 65 participants. AGD, the distance from anus to the posterior base of the scrotum, was measured with digital calipers. Anthropometric characteristics and testosterone levels of groups were recorded. We studied anogenital index (AGI), by dividing AGD by BMI to control bias of the weight and height, which could influence the measurement of AGD. The mean age of fathers was 61.5 ± 10.2 and that of children was 32.1 ± 5.48 (p = .00). The mean AGD scores were 55.46 ± 10.36 vs. 60.21 ± 10.04 (p = .09) and the mean total testosterone levels were 3.6 ± 1.47 vs. 5.45 ± 2.3 (p = .00) in group 1 and 2 respectively. There was no significant difference in height and weight between the two groups. AGD decreases with age, but further longitudinal studies are needed.
Topics: Adult; Aged; Aged, 80 and over; Aging; Humans; Male; Middle Aged; Perineum; Reference Values; Young Adult
PubMed: 31578741
DOI: 10.1111/and.13431 -
JMIR Dermatology Jan 2021Perineum sunning/tanning is a potentially harmful yet popular new health trend cultivated by a viral social media post, famous public figures, and subsequent media... (Observational Study)
Observational Study
BACKGROUND
Perineum sunning/tanning is a potentially harmful yet popular new health trend cultivated by a viral social media post, famous public figures, and subsequent media coverage.
OBJECTIVE
Our primary objective is to evaluate public interest in perineum sunning/tanning.
METHODS
Using an observational study design, we extracted data from Google Trends for the terms "perineum sunning," "perineum tanning," "Metaphysical Meagan," and "Josh Brolin"; and Twitter (via SproutSocial) for "perineum sunning" and "perineum tanning" from November 1, 2019, to December 31, 2019. UberSuggest was used to investigate monthly search volumes and user engagement. We used data from Google Trends and Twitter to construct autoregressive integrated moving average (ARIMA) models to forecast public interest in perineum sunning and perineum tanning had the post on social media never occurred. Next, we performed an integral function to calculate the cumulative increase in "perineum tanning" from the day after the post occurred to the end of the year as the area between the forecasted values and the actual values. Using Welch t tests, we compared forecasted and actual values for "perineum sunning" and "perineum tanning" using Twitter and Google Trends data over 1-, 2-, and 4-week periods after the social media post to determine if the increased volumes were statistically significant over time. Lastly, we monitored Google Trends for "perineum sunning" and "perineum tanning" through September 30, 2020, to capture trends during the summer months.
RESULTS
Before the Instagram post went viral, there was no search interest in perineum sunning. ARIMA modeling for perineum tanning forecasted no increase in searches (0.00) if the post had not gone viral, while actual interest conveyed a relative cumulative increase of 919.00% from the day the post went viral through December 31, 2020. The term "perineum sunning" was mentioned on average 804 (SD 766.1) times daily for this 7-day period, which was also significantly higher than predicted (P≤.03), totaling 5628 tweets for these 7 days. The increased volume of tweets and relative search interest from Google Trends remained significantly higher for both terms over the 1-, 2-, and 4-week intervals. User engagement showed that nearly 50% of people who searched for "perineum sunning" were likely to click a returned link for more information. Continued observance of search interest in perineum sunning demonstrated interest spikes in the summer months, June and July 2020.
CONCLUSIONS
Google Trends and Twitter data demonstrated that one social media post claiming non-evidence-based health benefits of regular sun exposure-without the use of sunscreen-generated significant public interest. Medical journals, dermatologists, and other health care professionals are obligated to educate and correct public misperceptions about viral wellness trends such as perineum sunning.
Topics: Humans; Perineum; Cross-Sectional Studies; Social Media; Sunbathing; Public Opinion
PubMed: 37632796
DOI: 10.2196/24124 -
International Urogynecology Journal Apr 2015Perineorrhaphy (Pe) has not been subject to a comprehensive perioperative quantitative assessment (QA). We wish to nominate such an assessment (Pe-QA) for any Pe,...
INTRODUCTION AND HYPOTHESIS
Perineorrhaphy (Pe) has not been subject to a comprehensive perioperative quantitative assessment (QA). We wish to nominate such an assessment (Pe-QA) for any Pe, through testing the QA on the excision of the perineal gap (PG) at the time of posterior repair (PR).
METHODS
At 50 consecutive PRs, the following measurements were taken pre- and postoperatively: (i) perineorrhaphy width (PW) equals PG [1]; (ii) perineorrhaphy depth (PD); (iii) perineal length (PL); (iv) midperineal thickness (MPT); (v) genital hiatus (GH) and (vi) total posterior vaginal length (TPVL). The total vaginal length was also measured. Surgical details deemed appropriate to each repair were recorded.
RESULTS
The overall means and ranges (cm) were: (i) PW 2.9 (1.5-5.5); (ii) PD 1.6 (0.8-2.0); (iii) PL 2.9 (1.5-4.5); (iv) MPT 0.7 (0.4-1.1); (v) GH 3.9 (2.3-6.5); (vi) TPVL 9.2 (6.0-12.5). Excision of PG (100 % cases reducing PW and PD to zero) resulted in a mean 23.6 % increase in total vaginal length over that if the repair was commenced at the hymen, despite a 3.3 % decrease in the TPVL perioperatively. There was a mean 30.8 % reduction in the GH, a mean 27.6 % increase in the PL and a mean 57.1 % increase in the MPT.
CONCLUSIONS
Pe and the anatomical results of such surgery can be subject to quantitative assessment allowing comparison studies between different forms of Pe and possibly other types of perineal surgeries.
Topics: Adult; Aged; Aged, 80 and over; Anatomic Landmarks; Female; Gynecologic Surgical Procedures; Humans; Middle Aged; Pelvic Organ Prolapse; Perineum; Vagina
PubMed: 25323311
DOI: 10.1007/s00192-014-2528-1 -
Diseases of the Colon and Rectum Nov 2018
Review
Topics: Adult; Anal Canal; Digestive System Surgical Procedures; Female; Humans; Patient Care Management; Perineum; Rectum; Trauma Severity Indices; Wounds, Penetrating
PubMed: 30286021
DOI: 10.1097/DCR.0000000000001221