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The Artificial Sphincter
Published in Han C. Kuijpers, Colorectal Physiology: Fecal Incontinence, 2019
Since some diffusion of fluid from the system may take place, resulting in decreased cuff pressure, another technical improvement has been the construction of a septum pump, which allows refilling of fluid into the system by percutaneous puncture. The technical complications described above have resulted in a total of eight re visional procedures in four patients. After modification of the system to its present form revision due to malfunctioning of the device has not been necessary. In eleven patients, the system has been in function for more than 6 months.3 Five patients were completely continent with only occasional leakage of gas and no outlet obstruction. Four patients occasionally leaked gas as well as liquid feces, none of them wore a pad. Two patients who suffered irritable bowel syndrome and frequent periods of constipation had obstructed defecation, which necessitated frequent use of laxatives and enemas. Both patients had a cuff only 10 cm long, but preferred the use of laxatives and enemas to reimplantation of a longer cuff.
Radical Sphincter-Sparing Resection in Rectal Cancer
Published in Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams, Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
The symptoms of bowel dysfunction vary widely, from daily episodes of incontinence of liquid stool or urgency through to constipation or obstructed defaecation. This cluster of symptoms is termed low anterior resection syndrome (LARS), which is pragmatically defined as disordered bowel function after rectal resection, leading to a detriment in quality of life.175
Rectal Prolapse and Other Causes of Fecal Obstruction
Published in Linda Cardozo, Staskin David, Textbook of Female Urology and Urogynecology - Two-Volume Set, 2017
Susanne D. Otto, Kaven Baessler, Jörn Gröne
obstructed defecAtion is defined As difficulty in evAcuAting the rectum despite the urge to defecAte. The most common cAuse is rectAl prolApse. A distinction is mAde between internAl rectAl prolApse (intussusception), where impAired evAcuAtion is the predominAnt symptom, And externAl rectAl prolApse, which leAds to fecAl incontinence. The only definitive treAtment is surgery. The ApproAch cAn be either perineAl or AbdominAl. While perineAl procedures hAve A lower complicAtion rAte, the relApse rAte is lower After AbdominAl procedures. However, both procedures often fAil to improve the initiAl complAints. Thus, it is necessAry to cArefully select pAtients for surgery And provide pAtients with detAiled informed consent. other cAuses of obstructed defecation are enterocele, rectocele, neurological disorders, and spinal cord injuries.
Statistical shape modeling of the pelvic floor to evaluate women with obstructed defecation symptoms
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2021
Megan R. Routzong, Ghazaleh Rostaminia, Shaniel T. Bowen, Roger P. Goldberg, Steven D. Abramowitch
Obstructed defecation symptoms (ODS) include prolonged straining to make a bowel movement and inability or manual assistance required to fully empty the rectum (Elshazly et al. 2010; Rojas et al. 2016; Rostaminia et al. 2020). ODS can be categorized into two types: 1) abdominal constipation with hard stool or infrequent bowel movement—defined as less than 3 times per week—and 2) pelvic constipation (Wingate et al. 2002; D’Hoore and Penninckx 2003). ODS are common, affecting approximately 7% of all adults, but 15-20% of adult women (Elshazly et al. 2010; Podzemny et al. 2015; Rostaminia et al. 2019). Although its etiology is still debated, it is hypothesized that the higher prevalence observed in women could be due to damage incurred by pelvic floor soft tissues and nerves during vaginal delivery (Ellis and Essani 2012).
Physiotherapist management of a patient with spastic perineal syndrome and subsequent constipation: a case report
Published in Physiotherapy Theory and Practice, 2021
Shankar Ganesh, Mritunjay Kumar
Constipation is a multi-factorial disorder and is defined as less than three bowel movements per week (Drossman, Sandler, McKee, and Lovitz, 1982). Constipation affects 2–28% of adults in the general population (Stewart et al., 1999) and negatively influences their quality of life (Glia and Lindberg, 1997). Constipation is classified as normal-transit constipation, obstructed defecation (functional type), or slow-transit constipation. In normal-transit constipation, there is normal coordination of the enteric neurons and gastrointestinal muscles. There is normal stool movement throughout the colon. However, the patients complain of constipation due to defecation disorder such as harder stools. Slow transit constipation is characterized by reduced motility in the gastrointestinal tract resulting in decreased and infrequent bowel movements. Obstructed defecation includes pelvic floor dyssynergia and anatomical abnormalities, such as rectocele, internal rectal prolapse, and solitary rectal ulcer (Beck, 2008).
Long-Term Functional Outcome after Internal Delorme's Procedure for Obstructed Defecation Syndrome, and the Role of Postoperative Rehabilitation
Published in Journal of Investigative Surgery, 2018
C. A. Leo, P. Campennì, J. D. Hodgkinson, P. Rossitti, F. Digito, G. De Carli, L. D'Ambrosi, P. Carducci, L. Seriau, G. Terrosu
Obstructed Defecation Syndrome (ODS) is a well-recognized problem that affects the quality of life of many patients. It is known as a functional and anatomical disorder of the pelvic floor. Rectocele, rectal intussusception, rectal prolapse (also known as procidentia), enterocele, and pelvic dissynergies (including anismus, levator muscle spasm) are all known to be associated with ODS. ODS occurs in approximately 7% of the population, and nearly 50% of patients with chronic constipation have ODS. Women are more likely to be affected than men are, and the prevalence increases with age. Treatment of ODS is not standardized and many different operative and nonoperative approaches have been described [1–4].