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Laparoscopic surgery and imaging-directed surgery for anorectal malformation
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Matthew W. Ralls, Marcus D. Jarboe
If no prior needle is in place, the space from the apex of the pubococcygeus muscle extending posteriorly is identified and developed. This will be the space through which the rectum will be passed. The vas deferens medially points to the prostate, which aids the surgeon in locating the urethra so as to avoid inadvertently injuring it. The lateral attachments of the colon may need to be mobilized in order to allow the rectum to reach the perineum.
Pelvic Floor Musculature
Published in Han C. Kuijpers, Colorectal Physiology: Fecal Incontinence, 2019
It is current practice to classify the muscle as comprising four constituent parts, each corresponding to an attachment from a pelvic bone, e.g., pubococcygeus (divided into two distinct components), iliococcygeus and ischiococcygeus. The peripheral attachment of the pelvic floor is linear, extending from the body of the pubic bone to the ischial spine and, in between these points, from a crescentic thickening of the obturator fascia referred to as the tendinous arch or “white line”. The two muscles arising from the pubic bone, pubococcygeus and puborectalis, have differing distributions and differing functions, the latter playing a major role in the function of anal continence. Most of the fibers of the pubococcygeus muscle are attached to a tendon that is inserted behind the rectum to the ventral aspect of the coccyx, so forming the ventral sacrococcygeal ligament.
The anus and anal canal
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
This problem is characterised by attacks of severe pain arising in the rectum, recurring at irregular intervals and apparently unrelated to organic disease. The pain is described as cramplike, often occurs when the patient is in bed at night, usually lasts only for a few minutes and disappears spontaneously. It may follow straining at stool, sudden explosive bowel action or ejaculation. It seems to occur more commonly in patients suffering from anxiety or undue stress, and it is also said to afflict young doctors. The pain may be unbearable - it is possibly caused by segmental cramp in the pubococcygeus muscle. It is unpleasant and incurable but is fortunately harmless and gradually subsides. If patients have frequent attacks, they may benefit from amitryptiline. Salbutamol inhalers have been suggested as treatment for acute attacks. A more chronic form of the disease has been termed the ‘levator syndrome' and can be associated with severe evacuatory dysfunction. Biofeedback techniques have been used to help such patients; in the past, some surgeons tried severing the puborectalis muscle, but this can cause incontinence and should never be carried out. If this is being consider an acceptable alternative is Botox into the puborectalis muscle.
Body Movement Is Associated With Orgasm During Vaginal Intercourse in Women
Published in The Journal of Sex Research, 2019
Annette Bischof-Campbell, Peter Hilpert, Andrea Burri, Karoline Bischof
Of the few studies exploring the specific role of stimulation techniques and muscular activity, the majority have focused on the role of pubococcygeus muscle training (Chambless et al., 1984), the coital alignment technique (Pierce, 2000), or women’s mental focus on vaginal sensation during intercourse (Brody & Weiss, 2010). Findings show that muscle tension or hip motion may have variable influence on coital orgasm (Clifford, 1978; de Bruijn, 1982; Leff & Israel, 1983) and that masturbation habits involving muscle tension such as squeezing thighs or pressing the genitals against pillows or furniture seem to be associated with more difficulties to reach orgasm in partner sex (Carvalheira & Leal, 2013). Apart from these few studies, to date the role of body movement during intercourse for women’s orgasm ability has received very little scientific attention.
Ankle positions potentially facilitating greater maximal contraction of pelvic floor muscles: a systematic review and meta-analysis
Published in Disability and Rehabilitation, 2019
Priya Kannan, Stanley Winser, Ravindra Goonetilleke, Gladys Cheing
The proposed mechanism of how ankle positions might affect PFM activity is related to the anterior and posterior pelvic tilts induced by dorsiflexion and plantar flexion, respectively [5,12,14]. Anterior pelvic tilt created by dorsiflexion is postulated to increase the pelvic outlet, move ischial tuberosities apart, and the sacrum and coccyx in an anterior and inferior direction, resulting in the closure of the sub-urethral vaginal wall, urethra, and bladder neck, and elevating the urethral support [12]. In addition, dorsiflexion induced changes at the pelvis, sacrum, and coccyx causes the attachments of the pubococcygeus muscle move closer, resulting in a shortening of the muscle fibers. These distortions are thought to increase the contractility of the PFM muscles [4,14].