-
Scientific Reports May 2024Pelvic floor dysfunctions (PFD) are highly prevalent among females who do athletics, a sport requiring jumping, strength, and running. Although educational approaches...
Pelvic floor dysfunctions (PFD) are highly prevalent among females who do athletics, a sport requiring jumping, strength, and running. Although educational approaches are useful options, the educational need for this particular population remains unknown. The objective of the present study was to describe the level of knowledge regarding PFD and its relationship with symptomatology and gender stereotypes in female athletes in Spain. A total of 255 female athletes completed an anonymous online survey to explore their knowledge regarding urinary incontinence (UI), pelvic organ prolapse (POP), anal incontinence (AI), and sexual dysfunction (SexD), as well as their PFD symptoms and gender stereotyped beliefs related to sport. Educational level and sports characteristics (training volume, experience, and athletic modality) were also explored. Participants demonstrated a low level of knowledge in terms of POP (52.5%), AI (64.0%), and SexD (40%), but not for UI (70.8%). The proportion of PFD complaints was 63.5% for dyspareunia, 51.8% for urine leakage, 42.4% for pelvic pain, 17.3% for AI, and 9.0% for POP, with no associations with knowledge (p > 0.05). Lower knowledge about UI and SexD was related to greater gender stereotypes (p < 0.05) and rejection of professional healthcare (p = 0.010). As a conclusion, the level of knowledge about PFD was low in female athletes who train and compete in athletics in Spain, mainly with regard to sexual dysfunction. Although 63.5% of athletes had dyspareunia and 51.8% urinary leakages, symptomatology was not associated with level of knowledge. However, a lower level of knowledge was associated with more stereotyped beliefs and rejection of professional healthcare for PFD. These findings confirm the need to design appropriate educational interventions to disseminate information on all the types of PFD, particularly sexual contents. The potential influence of gender stereotypes makes it appropriate to include the gender perspective in these interventions.
Topics: Humans; Female; Athletes; Adult; Stereotyping; Health Knowledge, Attitudes, Practice; Young Adult; Surveys and Questionnaires; Spain; Pelvic Floor Disorders; Urinary Incontinence; Pelvic Floor; Middle Aged; Adolescent
PubMed: 38744879
DOI: 10.1038/s41598-024-61464-x -
Alternative Therapies in Health and... May 2024To compare the application effects of tissue-selecting therapy stapler (TST), procedure for prolapse and hemorrhoids (PPH), and Ruiyun procedure for hemorrhoids (RPH) in...
Comparison of the Application Effects of Tissue-Selecting Therapy Stapler, Procedure for Prolapse and Hemorrhoids, and Ruiyun Procedure for Hemorrhoids in the Treatment of Mixed Hemorrhoids.
OBJECTIVE
To compare the application effects of tissue-selecting therapy stapler (TST), procedure for prolapse and hemorrhoids (PPH), and Ruiyun procedure for hemorrhoids (RPH) in the treatment of mixed hemorrhoids, specifically focusing on primary outcomes such as recovery time, pain levels, and quality of life.
METHODS
Based on the presence of mixed hemorrhoids,120 patients were admitted to the general surgery department of the hospital from January 2019 to December 2022 were selected and randomly divided into three groups, with 40 cases in each group. The parameters like VAS, ARP, SAP, and HF-QoL scores were chosen to comprehensively assess pain, anal function, and overall quality of life. Group A was treated with TST, group B was treated with PPH, and group C was treated with RPH. The parameters related to surgical treatment and rehabilitation, pain levels [Visual Analog Scale (VAS)] at different times, preoperative and postoperative anal dynamic function [anal rest pressure (ARP), squeeze anal pressure (SAP), and duration of contraction], anal function and quality of life were compared among the three groups. The incidence rates of complications that occurred within 1 month after surgery and postoperative recurrence rate were calculated.
RESULTS
There were significant differences in intraoperative blood loss, surgical time, length of hospital stay, and wound healing time among the three groups (TST, PPH, and RPH) (P < .05). There were statistically significant differences in VAS scores among the three groups (TST, PPH, and RPH) on the 1st and 2nd day after surgery (P < .05). The scores increased in sequence from group C, group A to group B. There was no statistically significant difference among the three groups (TST, PPH, and RPH) in terms of ARP, SAP, and duration of contraction before and after treatment, and Wexner scores at different time points after surgery (P > .05). There were statistically significant differences in HF-QoL scores among the three groups (TST, PPH, and RPH) at 1 month and 3 months after surgery (P < .05). One month after surgery, the HF-QoL score of group C was lower than those of groups A and B (P < .05). Three months after surgery, the HF-QoL scores increased in sequence from group C, group A to group B (P < .05). There were statistically significant differences in the incidence rates of urinary retention and anal stenosis among the three groups (TST, PPH, and RPH) (P < .05). The incidence rates of urinary retention and anal stenosis in group B were much higher than those in group B, group A and group C (P < .05).
CONCLUSION
RPH not only shows superiority in treating mixed hemorrhoids in terms of intraoperative blood loss, surgical time, postoperative pain, and quality of life, but also holds promise for enhancing clinical practices with potentially shorter hospital stays and improved patient outcomes.
PubMed: 38743889
DOI: No ID Found -
Biologics : Targets & Therapy 2024The patient was a 50-year-old Japanese woman who was diagnosed with total-colitis-type ulcerative colitis (UC) at the age of 26 years. She was treated with mesalazine...
The patient was a 50-year-old Japanese woman who was diagnosed with total-colitis-type ulcerative colitis (UC) at the age of 26 years. She was treated with mesalazine and azathioprine, and her disease activity was well controlled. At the age of 50 years, the patient was experiencing fever, abdominal pain, diarrhea, bloody stool, and anal pain, which led to a diagnosis of a relapse of UC. Although steroid therapy was administered and tended to improve her symptoms, fecaloid vaginal discharge occurred, and rectovaginal fistula (RVF) was confirmed. Colostomy was performed, and infliximab was initiated as maintenance therapy for UC. All symptoms improved, and RVF closure was confirmed 6 months after the initiation of infliximab. To date, she has been free from relapse of UC. There have been only a few reports of UC complicated by RVF, and this condition is often difficult to treat. To the best of our knowledge, no other case of UC complicated by RVF in which the fistula was closed after treatment with colostomy and infliximab has been previously reported; thus, our report of the present case is valuable to the literature.
PubMed: 38736705
DOI: 10.2147/BTT.S457300 -
Journal of Pharmaceutical and... Aug 2024Amomum tsaoko (AT) is commonly used in clinical practice to treat abdominal distension and pain. It is also a seasoning for cooking, with the functions of appetizing,... (Comparative Study)
Comparative Study
Amomum tsaoko (AT) is commonly used in clinical practice to treat abdominal distension and pain. It is also a seasoning for cooking, with the functions of appetizing, invigorating the spleen, and being digestive-promoting. Amomum tsaoko (AT) has three adulterants, Amomum paratsaoko (AP), Amomum koenigii (AK), and Alpinia katsumadai Hayata, because of the confusion in historical classics regarding recorded sources as well as the near geographic distribution and fruit morphological similarities. In this study, we established a functional dyspepsia (FD) rat model and then treated it with the corresponding medicinal solutions AT, AP, AK, and AKH. The gastric emptying rate, intestinal propulsion rate, serum biochemical indicators, histopathological changes, and fecal metabolism were measured. The efficacy and mechanism of AT, AP, AK, and AKH in the treatment of FD were compared. Fecal metabolomics revealed that 20 potential biomarkers were involved in seven significant metabolic pathways in FD rats. These pathways include ubiquinone and other terpenoid-quinone biosynthesis, glycerophospholipid metabolism, tyrosine metabolism, primary bile acid biosynthesis, purine metabolism, folate biosynthesis, and amino sugar and nucleotide sugar metabolism. AP regulates 6 metabolic pathways, 5 metabolic pathways affected by AT, 4 metabolic pathways affected by AK, and 2 metabolic pathways affected by AKH.The above results suggest that the different effects of AT, AP, AK, and AKH on FD rats may be due to their different regulatory effects on the metabolome.
Topics: Animals; Metabolomics; Rats; Amomum; Dyspepsia; Male; Rats, Sprague-Dawley; Feces; Biomarkers; Gastric Emptying; Disease Models, Animal; Plant Extracts; Drugs, Chinese Herbal
PubMed: 38735210
DOI: 10.1016/j.jpba.2024.116208 -
Medicine May 2024The efficacy of surgical intervention for perianal infection in patients with hematologic malignancies is not well established. Therefore, our study aimed to investigate...
The efficacy of surgical intervention for perianal infection in patients with hematologic malignancies is not well established. Therefore, our study aimed to investigate the clinical efficacy and complications of surgical treatment of perianal infection in patients with hematologic malignancies. This retrospective study included patients with hematological malignancies who were diagnosed with perianal infections and treated at the China Aerospace Science & Industry Corporation 731 Hospital between 2018 and 2022. Patient characteristics, hematological data, surgical intervention, and complications, including recurrence and mortality, were analyzed. This study included 156 patients with leukemia aged 2 months to 71 years who were treated surgically for perianal infection, comprising 94 males and 62 females. Perianal infection included 36 cases of abscesses, 91 anal fistulas, and 29 anal fissures accompanied by infection. A total of 36 patients developed severe complications postoperatively, including 4 patients who died, 6 patients with severe incision bleeding, 18 patients with severe pain, 6 patients with sepsis, 12 patients who needed reoperation, 15 patients with hospitalization for more than 2 weeks, and 3 patients with anal stenosis; none of the patients developed anal incontinence. Additionally, risk factors for postoperative complications of perianal infection in patients with hematologic malignancies include leukopenia, agranulocytosis, thrombocytopenia, depth of abscess and not undergone an MRI. Surgical intervention may improve the prognosis of patients with perianal abscess formation, particularly in patients who show no improvement with medical therapy and those who develop perianal sepsis. Granulocytopenia and thrombocytopenia should be improved before surgery, which can significantly reduce postoperative complications. Although these findings are from a case series without a comparator, they may be of value to physicians because to the best of our knowledge, no randomized or prospective studies have been conducted on the management of perianal infections in patients with hematological malignancies.
Topics: Humans; Male; Female; Retrospective Studies; Middle Aged; Adult; Aged; Hematologic Neoplasms; Abscess; Adolescent; Child; Young Adult; Anus Diseases; Child, Preschool; Postoperative Complications; Infant; Rectal Fistula; Treatment Outcome; Fissure in Ano
PubMed: 38728504
DOI: 10.1097/MD.0000000000038082 -
Surgical Case Reports May 2024Colorectal cancer (CRC) often metastasizes to the liver, lungs, lymph nodes, and peritoneum but rarely to the bladder, small intestine, and skin. We here report the rare...
BACKGROUND
Colorectal cancer (CRC) often metastasizes to the liver, lungs, lymph nodes, and peritoneum but rarely to the bladder, small intestine, and skin. We here report the rare metastasis of anal cancer in the left bladder wall, followed by metastases to the small intestine and skin, after abdominoperineal resection and left lateral lymph node dissection with chemotherapy in a patient with clinician Stage IVa disease.
CASE PRESENTATION
A 66-year-old man presented with 1-month history of bloody stool and anal pain and diagnosed with clinical Stage IVa anal cancer with lymph node and liver metastases (cT3, N3 [#263L], M1a [H1]). Systemic chemotherapy led to clinical complete response (CR) for the liver metastasis and clinical near-CR for the primary tumor. Robot-assisted laparoscopic perineal rectal resection and left-sided lymph node dissection were performed. Computed tomography during 18-month postoperative follow-up identified a mass in the left bladder wall, which was biopsied with transurethral resection, was confirmed as recurrent anal cancer by histopathologic evaluation. After two cycles of systemic chemotherapy, partial resection of the small intestine was performed due to bowel obstruction not responding to conservative therapy. The histopathologic evaluation revealed lymphogenous invasion of the muscularis mucosa and subserosa of all sections. Ten months after the first surgery for bowel obstruction and two months before another surgery for obstruction of the small intestine, skin nodules extending from the lower abdomen to the thighs were observed. The histopathologic evaluation of the skin biopsy specimen collected at the time of surgery for small bowel obstructions led to the diagnosis of skin metastasis of anal cancer. Although panitumumab was administered after surgery, the patient died seven months after the diagnosis of skin metastasis.
CONCLUSIONS
This case illustrates the rare presentation of clinical Stage IVa anal cancer metastasizing to the bladder wall, small intestine, and skin several years after CR to chemotherapy.
PubMed: 38714637
DOI: 10.1186/s40792-024-01913-x -
Investigative and Clinical Urology May 2024Pudendal neuropathy is an uncommon condition that exhibits several symptoms depending on the site of nerve entrapment. This study aims to evaluate the efficacy of... (Review)
Review
PURPOSE
Pudendal neuropathy is an uncommon condition that exhibits several symptoms depending on the site of nerve entrapment. This study aims to evaluate the efficacy of pudendal nerve neurolysis (PNN) in improving lower urinary tract symptoms, anal and/or urinary incontinence, and sexual dysfunctions.
MATERIALS AND METHODS
A systematic literature search was performed on 20 May 2023 using Scopus, PubMed, and Embase. Only English and adult papers were included. Meeting abstracts and preclinical studies were excluded.
RESULTS
Twenty-one papers were accepted, revealing significant findings in the field. The study identified four primary sites of pudendal nerve entrapment (PNE), with the most prevalent location likely being at the level of the Alcock canal. Voiding symptoms are commonly exhibited in patients with PNE. PNN improved both urgency and voiding symptoms, and urinary and anal incontinence but is less effective in cases of long-standing entrapment. Regarding sexual function, the recovery of the somatic afferent pathway results in an improvement in erectile function early after neurolysis. Complete relief of persistent genital arousal disorder occurs in women, although bilateral PNN is necessary to achieve the efficacy. PNN is associated with low-grade complications.
CONCLUSIONS
PNN emerges as a viable option for addressing urinary symptoms, fecal incontinence, erectile dysfunction, and female sexual arousal in patients suffering from PNE with minimal postoperative morbidity.
Topics: Humans; Pudendal Nerve; Pudendal Neuralgia; Fecal Incontinence; Treatment Outcome; Sexual Dysfunction, Physiological; Nerve Block; Male Urogenital Diseases; Female Urogenital Diseases; Urinary Incontinence
PubMed: 38714513
DOI: 10.4111/icu.20230402 -
Cureus Apr 2024Deep-tissue extension of perianal and perirectal abscesses, while rare, requires timely diagnosis and emergent surgical intervention to prevent serious secondary...
Deep-tissue extension of perianal and perirectal abscesses, while rare, requires timely diagnosis and emergent surgical intervention to prevent serious secondary complications. This report evaluates a case of intra-abdominal and extraperitoneal extension of a persistent perirectal abscess that required comprehensive irrigation, drainage, and debridement of multiple abscess-associated cavities. This report follows the case of a 24-year-old African-American female presenting to the ED with mild fevers, nausea, abdominal distension, and lower abdominal pain following a persistent perirectal abscess that had not resolved following conservative outpatient antibiotic management one week prior. Clinical examination revealed abdominal guarding with CT imaging demonstrating extraluminal air pockets in multiple intra-abdominal and extraperitoneal compartments. The patient underwent emergent surgical irrigation, drainage, and debridement of multiple abscess cavities extending from the original perirectal abscess. This report provides a comprehensive overview of the diagnosis, surgical approach, and postoperative management in a patient presenting with a complex tunneling perirectal abscess forming intra-abdominal and extraperitoneal abscesses.
PubMed: 38711725
DOI: 10.7759/cureus.57688 -
Cureus Apr 2024Introduction Anorectal diseases are prevalent in the general population and may vary from benign disorders to malignant lesions that can metastasize. There is a variety...
Introduction Anorectal diseases are prevalent in the general population and may vary from benign disorders to malignant lesions that can metastasize. There is a variety of proctologic symptoms associated with each disease. The incidence of proctologic disease varies in different cultures due to dietary habits and variations in lifestyle. The present study was conducted to determine the spectrum of different proctologic diseases in female patients presenting with proctologic symptoms. Methods This cross-sectional study was conducted in the Surgery Department of Mardan Medical Complex, Mardan, and Khyber Teaching Hospital, Peshawar, from January 2022 to January 2023. Female patients with proctologic symptoms were included, while non-consenting patients were excluded. After obtaining a detailed history and examination by the experienced surgeon, digital rectal examination and proctoscopy/sigmoidoscopy were performed where necessary. Diagnoses were made, and the data regarding proctologic symptoms and their corresponding diagnoses was analyzed using Statistical Package for the Social Sciences (SPSS) version 20.0 (IBM SPSS Statistics, Armonk, NY) using mean and standard deviation for quantitative variables and frequency and percentage for qualitative variables. Results The mean age of 500 female study participants was 38.35±16.305 (range: 7-108) years. Bleeding per rectum, constipation, and pain per rectum were the commonest proctologic symptoms seen in 341 (68.2%), 287 (57.4%), and 272 (54.4%) cases, respectively. Anal fissures and hemorrhoids were the commonest proctologic diseases seen in 264 (52.8%) and 60 (12%) cases, respectively. Conclusion Bleeding per rectum is the commonest proctologic symptom in patients. Anal fissures and hemorrhoids are the commonest proctologic diseases in our setup. Bleeding per rectum and hemorrhoids in the female population cause loss of blood, which in turn will aggravate the clinical picture of underlying anemia, if any.
PubMed: 38707048
DOI: 10.7759/cureus.57600 -
International Journal of Surgery Case... Jun 2024Buschke-Löwenstein tumor (BLT) is a rare perianal lesion caused by low-risk mucosal HPV 6 or 11 but less frequently associated with high-risk HPV types. It is a large,...
INTRODUCTION AND IMPORTANCE
Buschke-Löwenstein tumor (BLT) is a rare perianal lesion caused by low-risk mucosal HPV 6 or 11 but less frequently associated with high-risk HPV types. It is a large, exophytic, verrucous lesion of the anogenital region. BLT presents as a benign tumor but exhibits malignant clinical behavior and has a high rate of local recurrence and malignant transformation. The optimal treatment approach for BLT is still debated due to the lack of consensus. Various therapeutic modalities have been proposed, including topical agents, surgical excision, immunotherapy, chemo-radiotherapy, and electrocoagulation.
CASE PRESENTATION
This case report presents a heterosexual, immunocompetent patient with anal pain, pruritus, and spontaneous bleeding. The physical examination revealed an exophytic, pedunculated verrucous lesion, which appeared to be a typical fibroepithelial lesion.
CLINICAL DISCUSSION
The patient underwent wide excision, followed by a re-excision due to a surgical margin issue. The tumor exhibited malignant transformation into a well-differentiated SCC. However, due to the tumor's stage, size, location, histological type, and the extended time interval between the two surgeries, postoperative radiotherapy was not performed. Follow-up examinations over 12 months revealed no evidence of recurrence in either the patient's clinical evaluation or pelvic MRI.
CONCLUSIONS
Although comprehensive research is lacking, wide local excision is considered the preferred first-line treatment for early-stage cases without evidence of local invasion. Furthermore, HPV immunization can prevent the development of Buschke-Löwenstein tumor, and early administration of the HPV vaccine is recommended to avoid acquiring HPV infection.
PubMed: 38704971
DOI: 10.1016/j.ijscr.2024.109715