-
Veterinary Medicine and Science Feb 2019Understanding the homologies between male and female perineal structure helps both evolutionary biologists and clinicians better understand the evolution and anatomy of...
Understanding the homologies between male and female perineal structure helps both evolutionary biologists and clinicians better understand the evolution and anatomy of canines. Domestic dogs (Canis familiaris) play an important role in human society, and canine perineal anatomy is important for maintaining dogs' reproductive health for successful breeding and a wide variety of pathologies. Here, we investigate homologies between male and female perineal structure, identifying structures based on common function, anatomical relationships and attachments. In this investigation we dissected 21 male and female large-breed dogs. We find broad structural homologies between male and female dogs related to erection, micturition and defecation, including muscles, fasciae and erectile tissue. Using these homologies will help anatomists and clinicians interpret the anatomical organization of the perineum, a notoriously difficult area of anatomy.
Topics: Animals; Dogs; Female; Genitalia, Female; Genitalia, Male; Male; Perineum
PubMed: 30663868
DOI: 10.1002/vms3.128 -
Acta Dermato-venereologica Aug 2022
Topics: Aged; Buttocks; Erythema; Female; Hamartoma; Humans; Pain; Perineum; Pruritus
PubMed: 35788689
DOI: 10.2340/actadv.v102.2436 -
Journal de Gynecologie, Obstetrique Et... Feb 2006Attempt to define the most appropriate care after an episiotomy, the best-suited treatments of the pain of episiotomy, and examine the course of repair stitches. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Attempt to define the most appropriate care after an episiotomy, the best-suited treatments of the pain of episiotomy, and examine the course of repair stitches.
MATERIAL AND METHODS
A survey of the literature found on Medline and on the Cochrane Library between 1990 and 2005, and dealing with these questions was carried out.
RESULTS
As regards local care, the best possible personal hygiene is a key to healing, but no specific treatment has been accepted. The treatment of pain by non-medical means as well as topically is not very efficient. Nonsteroidal antiinflammatory drugs were the most studied among medical treatments and have shown an effect on pain (whether per os or by rectal route), some of them can be used during maternal breastfeeding. Acetaminophen has not been sufficiently studied to assess its effectiveness.
CONCLUSION
The medical staff must emphasize the importance of self care and personal hygiene. The pain of episiotomy is a crucial element to treat, and it is most effectively done medically. The treatment must be adapted to each patient depending on her tolerance and whether she is breastfeeding or not.
Topics: Adult; Anti-Inflammatory Agents, Non-Steroidal; Breast Feeding; Episiotomy; Female; Humans; Hygiene; Pain, Postoperative; Perineum; Postoperative Care; Pregnancy; Treatment Outcome; Wound Healing
PubMed: 16495827
DOI: No ID Found -
Tidsskrift For Den Norske Laegeforening... Oct 2021Surgical procedures in the perineum can cause major soft-tissue defects that require reconstruction with plastic surgery. In this article we present plastic surgery...
Surgical procedures in the perineum can cause major soft-tissue defects that require reconstruction with plastic surgery. In this article we present plastic surgery principles for the reconstruction of wound defects and common methods used to reconstruct wound defects in the perineum.
Topics: Humans; Perineum; Plastic Surgery Procedures; Surgery, Plastic
PubMed: 34726052
DOI: 10.4045/tidsskr.21.0161 -
International Journal of Legal Medicine Mar 2022Examinations of young children for suspicions of sexual abuse are challenging for the involved medical specialists because the consequences of the interpretation of the...
Examinations of young children for suspicions of sexual abuse are challenging for the involved medical specialists because the consequences of the interpretation of the findings can be severe and dramatic. A broad knowledge of differential diagnoses including rare pathologies like urethral prolapse and failure of the midline fusion of the perineum, known as perineal groove, is essential in order to avoid unnecessary diagnostics and treatment, prejudgment, and to reduce patient family's anxiety. We report two independent cases of girls aged 7 months and 5 years suffering from these rare pathologies, one presenting with painless lower genital tract bleeding, the other showing a lesion of the perineum as random finding during a neuropediatrician's consultation. In both cases, the pathologies were initially misdiagnosed as injuries due to sexual assault, and judicial investigation procedures were initiated. In this paper, the characteristic symptoms and morphology of urethral prolapse and perineal groove are presented to enhance the awareness of these pathologies among forensic experts and help to establish the correct diagnosis.
Topics: Child; Child Abuse, Sexual; Child, Preschool; Female; Hemorrhage; Humans; Perineum; Sex Offenses; Urethral Diseases; Vagina
PubMed: 34057591
DOI: 10.1007/s00414-021-02621-z -
International Urogynecology Journal Oct 2016There is conflicting evidence on whether mediolateral episiotomy (MLE) reduces the risk of obstetric anal sphincter injuries (OASI) in spontaneous vaginal deliveries... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
There is conflicting evidence on whether mediolateral episiotomy (MLE) reduces the risk of obstetric anal sphincter injuries (OASI) in spontaneous vaginal deliveries (SVD).
OBJECTIVES
A systematic review was undertaken to compare rates of OASI amongst women who had undergone mediolateral episiotomy versus those who did not.
SEARCH STRATEGY
Electronic searches were performed in literature databases: CINAHL, Cochrane, EMBASE, Medline and MIDIRS from database inception to July 2015. Studies were eligible if MLE was compared to spontaneous tears and if OASI was the outcome of interest. Two reviewers independently selected and extracted data on study characteristics, quality and results. We computed events of OASI in those who did and did not have an episiotomy from individual studies and pooled these results in a meta-analysis where possible.
MAIN RESULTS
Of the 2090 citations, 16 were included in the review. All were non-randomised, population based or retrospective cohort studies. There was great variation in quality amongst these studies. Data from 7 studies was used for meta-analysis. On collating data from these studies where the majority of women (636755/651114) were nulliparous, MLE reduced the risk of OASI (RR 0.67 95 % CI 0.49-0.92) in vaginal delivery.
CONCLUSION
The pooled analysis of a large number of women undergoing vaginal birth, most of who were nulliparous, indicates that MLE has a beneficial effect in prevention of OASI. An accurately given MLE might have a role in reducing OASI and should not be withheld, especially in nulliparous women. Caution is advised as the data is from non-randomised studies.
Topics: Anal Canal; Case-Control Studies; Delivery, Obstetric; Episiotomy; Female; Humans; Perineum; Pregnancy; Retrospective Studies; Risk; Vagina
PubMed: 26894605
DOI: 10.1007/s00192-016-2956-1 -
BMJ Case Reports Apr 2017A 45-year-old woman with a history of total hysterectomy with adnexal preservation for uterine leiomyomas presented to our hospital with a right gluteal palpable mass,...
A 45-year-old woman with a history of total hysterectomy with adnexal preservation for uterine leiomyomas presented to our hospital with a right gluteal palpable mass, which she first noticed 6 months before and had progressively enlarged since then.Radiological studies revealed a 14 cm lesion with translevator growth that displaced rather than invaded adjacent structures, with a peculiar whorled pattern on T2-weighted MRI, which enhanced following gadolinium administration. CT-guided biopsy was performed, and in conjunction with imaging features the diagnosis of an aggressive angiomyxoma was assumed and confirmed following surgical excision.
Topics: Biopsy; Female; Humans; Magnetic Resonance Angiography; Middle Aged; Myxoma; Perineum; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 28400400
DOI: 10.1136/bcr-2016-217705 -
The Cochrane Database of Systematic... Aug 2011Perineal tears commonly occur during childbirth. They are sutured most of the time. Surgical repair can be associated with adverse outcomes, such as pain, discomfort and... (Review)
Review
BACKGROUND
Perineal tears commonly occur during childbirth. They are sutured most of the time. Surgical repair can be associated with adverse outcomes, such as pain, discomfort and interference with normal activities during puerperium and possibly breastfeeding. Surgical repair also has an impact on clinical workload and human and financial resources.
OBJECTIVES
To assess the evidence for surgical versus non-surgical management of first- and second-degree perineal tears sustained during childbirth.
SEARCH STRATEGY
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (1 May 2011), CENTRAL (The Cochrane Library 2011, Issue 2 of 4) and MEDLINE (Jan 1966 to 2 May 2011). We also searched the reference lists of reviews, guidelines and other publications and contacted authors of identified eligible trials.
SELECTION CRITERIA
Randomised controlled trials (RCTs) investigating the effect on clinical outcomes of suturing versus non-suturing techniques to repair first- and second-degree perineal tears sustained during childbirth.
DATA COLLECTION AND ANALYSIS
Two review authors independently assessed trials for inclusion and assessed trial quality. Three review authors independently extracted data.
MAIN RESULTS
We included two RCTs (involving 154 women) with a low risk of bias. It was not possible to pool the available studies. The two studies do not consistently report outcomes defined in the review. However, no significant differences were observed between the two groups (surgical versus non-surgical repair) in incidence of pain and wound complications, self-evaluated measures of pain at hospital discharge and postpartum and re-initiation of sexual activity. Differences in the use of analgesia varied between the studies, being high in the sutured group in one study. The other trial showed differences in wound closure and poor wound approximation in the non-suturing group, but noted incidentally also that more women were breastfeeding in this group.
AUTHORS' CONCLUSIONS
There is limited evidence available from RCTs to guide the choice between surgical or non-surgical repair of first- or second-degree perineal tears sustained during childbirth. Two studies find no difference between the two types of management with regard to clinical outcomes up to eight weeks postpartum. Therefore, at present there is insufficient evidence to suggest that one method is superior to the other with regard to healing and recovery in the early or late postnatal periods. Until further evidence becomes available, clinicians' decisions whether to suture or not can be based on their clinical judgement and the women's preference after informing them about the lack of long-term outcomes and the possible chance of a slower wound healing process, but possible better overall feeling of well being if left un-sutured.
Topics: Adult; Female; Humans; Lacerations; Obstetric Labor Complications; Perineum; Pregnancy; Randomized Controlled Trials as Topic; Rupture, Spontaneous; Soft Tissue Injuries; Watchful Waiting
PubMed: 21833968
DOI: 10.1002/14651858.CD008534.pub2 -
Zhongguo Xiu Fu Chong Jian Wai Ke Za... Oct 2020To explore the suitable division of male genitalia subunits and the effectiveness of large-area perineum defect repair under its guidance.
OBJECTIVE
To explore the suitable division of male genitalia subunits and the effectiveness of large-area perineum defect repair under its guidance.
METHODS
According to the anatomical and functional characteristics of male genitalia, the subunit division scheme was proposed: area Ⅰ, glans penis; area Ⅱ, body of penis; area Ⅲ, scrotum; area Ⅳ, scrotum. Between April 2017 and July 2019, 12 patients with large genitalia defects were treated, with an average age of 60.9 years (range, 57-66 years) and an average disease duration of 2.7 years (range, 2-5 years). The defect area involved area Ⅰ in 1 case, area Ⅱ in 7 cases, area Ⅲ in 5 cases, and area Ⅳ in 8 cases; the size of area ranged from 6 cm×4 cm to 23 cm×16 cm. The causes of defect included 3 cases of trauma, 6 cases of Paget disease, 2 cases of squamous cell carcinoma, 1 case of spindle cell tumor. According to the design of the corresponding repair scheme, the main repair methods were to rotate and advance the skin flap and pedicled skin flap in the same area. When the defect was large, the free skin flap transplantation, free skin grafting, and free mucosa transplantation were used to repair the defect.
RESULTS
All the patients were followed up 6-13 months with an average of 8.6 months. Skin flap, skin graft, and mucosa survived in one stage in 10 patients; infection occurred in 1 case after the scrotal flap of area Ⅲ was transferred to repair the defect in area Ⅱ, 1 case had distal venous crisis at 2 days after repair area Ⅲ defect used free anterolateral thigh flap, and after active treatment, the condition improved. The appearance of the receiving area and the supplying area was good, and the local feeling was recovered satisfactorily. The range of motion of hip joint was good in 10 cases, and 2 cases were slightly stretched but did not affect normal life. All patients had normal urination and defecation function, and were satisfied with the treatment effectiveness.
CONCLUSION
The subunits of male genitalia can be used to guide the repair of the defect, which can better restore the physiological appearance and function, and has positive clinical significance.
Topics: Aged; Humans; Male; Middle Aged; Perineum; Plastic Surgery Procedures; Skin Transplantation; Soft Tissue Injuries; Thigh
PubMed: 33063495
DOI: 10.7507/1002-1892.202003154 -
Deutsches Arzteblatt International Oct 2021
Topics: Humans; Nevus; Perineum; Skin Neoplasms
PubMed: 35086638
DOI: 10.3238/arztebl.m2021.0073