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Journal of Neurology, Neurosurgery, and... Jun 2000The objective was to describe perineal electrophysiological findings and to determine their diagnostic value in a type of lumbosacral plexopathy after vaginal delivery,...
The objective was to describe perineal electrophysiological findings and to determine their diagnostic value in a type of lumbosacral plexopathy after vaginal delivery, which only involves the lower part of the plexus (S2-S4). Consecutive female patients referred to an outpatients' urodynamic clinic were the source. Nineteen previously healthy women, 13 multiparae and six para 1, were investigated. Mean age was 33.7 (SD 5.4) (range 28-41) years. All of them presented with urinary (stress incontinence 14, dysuria five), anorectal (faecal incontinence eight, dyskesia one), or sexual dysfunctions (hypoorgasmia or anorgasmia six) after vaginal delivery. No associated lower limb sensory or motor deficits were noted. All the patients had electrophysiological recordings (bulbocavernosus muscle EMG, measurements of the bulbocavernosus reflex latencies (BCRLs), somatosensory evoked potentials of the pudendal nerve (SEPPNs), and pudendal nerve terminal motor latencies (PNTMLs)). Cystometry and urethral pressure profile (UPP) were performed in the 14 patients with stress urinary incontinence. Perineal electrophysiological examination disclosed signs of denervation in the perineal muscles in all the cases, prolonged BCRLs in 17/19, and abolished BCRLs in 2/19, abnormal SEPPN in 1/19, and normal PNTMLs in all the patients. Urodynamic investigations disclosed low urethral closure pressure for age (< 50 cm H(2)O) in half of the patients. In conclusion, Lower postpartum lumbosacral plexopathy is evoked when perineal sensory disturbances whether or not associated with urinary or faecal incontinence persist after a history of a difficult vaginal delivery. Electrophysiological investigations precisely identify the site of the lesion and demonstrate distal innervation integrity.
Topics: Adult; Autonomic Nervous System Diseases; Fecal Incontinence; Female; Follow-Up Studies; Humans; Lumbosacral Plexus; Male; Perineum; Puerperal Disorders; Reaction Time; Reflex, Abnormal; Retrospective Studies; Urinary Incontinence; Urodynamics
PubMed: 10811704
DOI: 10.1136/jnnp.68.6.771 -
Turk Psikiyatri Dergisi = Turkish... 2007The aim of this study was to investigate the effects of permanent ostomy on body image, sexual functioning, self-esteem, and marital adjustment.
OBJECTIVE
The aim of this study was to investigate the effects of permanent ostomy on body image, sexual functioning, self-esteem, and marital adjustment.
METHOD
SCID-I outpatient forms were administered to 52 subsequent patients that underwent permanent colostomy or ileostomy operations, and 40 of them that did not fit any of the diagnostic criteria for psychiatric disorders were then administered a sociodemographic data questionnaire, and the Body Image Scale, Rosenberg Self-Esteem Scale, Dyadic Adjustment Scale, and Golombok Rust Sexual Functions scale. The control group consisted of 20 age- and gender-matched healthy volunteers.
RESULTS
Body Image, Rosenberg Self-Esteem, and Dyadic Adjustment Scale scores were higher in permanent ostomy patients compared to controls, indicating more ostomy-related disturbance. Sexual functions were found to be impaired as well, except impotence and rapid ejaculation parameters. Complaints of anorgasmia were more frequent among female colostomy patients. Body image, and the touch, communication, and frequency parameters of sexual functioning were less disturbed in male patients than in females. Female patients with a psychiatric history experienced vaginismus problems more frequently. Patients with a history early childhood separation from parents had lower self-esteem scores and more frequently avoided sexual activity. Following ostomy surgery, the frequency of male impotence decreased over time.
CONCLUSION
Permanent ostomy causes impairment in perceived body image, dyadic adjustment, and sexual functioning.
Topics: Body Image; Colostomy; Female; Humans; Male; Middle Aged; Psychiatric Status Rating Scales; Self Concept; Sexual Dysfunctions, Psychological; Sexuality; Social Adjustment; Surveys and Questionnaires
PubMed: 18066721
DOI: No ID Found