Editorial Editorial

Cover This month we are pleased to present a range of clinical papers from urology, gynaecology and coloproctology that maintain the standard set in our first English issue. Pelviperineology is focussing on clinical papers that provide practical information that is of use to the clinician. [More]

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Original ArticleCadaveric study of ACT® balloons and their impact on female sexual anatomy by Helen E. O’Connell - Sanjeevan Kalavampara - Bruno Frea Peter Robertson - Ervin Kocjancic

female sexual anatomyThe adjustable continence therapy (ACT®) device has been developed for the treatment of intrinsic sphincter deficiency (ISD) using a standardised surgical technique to optimise continence efficacy. This study examined the extent of structural disruptions caused by its insertion and the possible impact of this device on female sexual anatomy. [More]

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Clinical Practice Sonography of the female pelvic floor : clinical indications and techniques by Vittorio Luigi Piloni - Liana Spazzafumo

female perineumPelvic floor dysfunction usually leads to structural alterations in all compartments of the female pelvis. In advanced cases, with involvement of more than one compartment, accurate identification of all structures is essential to surgical planning and success. Clinical diagnosis may be difficult so an examination that provides a wide and simultaneous evaluation of all pelvic regions is highly desirable. [More]

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Review Understanding Chronic Pelvic Pain by Marek Jantos

pain managementThe importance of pain management in patient care is reflected in the recognition of pain as the fifth vital sign. As a results pain needs to be assessed and charted together with temperature, respiration, pulse, and blood pressure whenever a patient undergoes medical review. However, unlike the other vital signs, pain is difficult to define in ways that provide the clinician with practical, workable options. [More]

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Original ArticlePosterior IVS for vault suspension: A re-evaluation by Bruce Farnsworth

PIVSThe PIVS was originally described by Petros as a vault suspension procedure. It was presented as an alternative to the sacrospinous fixation, transabdominal sacropexy and McCull culdoplasty. As a day surgery procedure it had the potential to be used in a number of patients with medical conditions that made traditional surgery seem too risky to consider routinely. [More]

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Clinical PracticeShort-IPGH system for assessment of pelvic floor disease by Bruce Farnsworth - Giuseppe Dodi

short-ipghWhen assessing pelvic floor problems, clinicians should make a balanced evaluation of any dysfunction which takes into account all three pelvic compartments in addition to any general medical conditions including the consequences of neurological disease. A number of systems have been devised to analyse, diagnose and quantify pelvic dysfunction. [More]

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Original ArticleClinical and functional results after tailored surgery for rectovaginal fistula by Giuseppe Gagliardi - Mario Pescatori

tableRecto-vaginal fistulae (RVF) are complex fistulae particularly difficult to treat. Their frequency is relatively low, representing less then 5% of anorectal fistulae. Obstetric injury is by far the most frequently reported cause of low recto-vaginal fistulae.  [More]

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Clinical auditComparison of transobturator sling procedures for genuine stress urinary incontinence in the short to medium term by Bernie Brenner

transobturator approach for sling placement The suburethral sling has become the main operation for the surgical management of stress urinary incontinence in women. The transobturator approach for sling placement has gained popularity and the technique and variety of commercially available materials has been well covered in the literature. [More]

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Expert OpinionBowel dysfunction in spinal cord injury patients: pathophysiology and management by Gabriele Bazzocchi - Christoffel Schuijt - Roberto Pederzini - Mauro Menarini

bowel dysfunctionDigestive function is one of the greatest problems for people with spinal cord injuries, particularly control of evacuation. Bowel disorders play an important part in the course of rehabilitation following spinal injury, in terms of both quality of life and morbidity and mortality. [More]

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Original ArticleAnatomical basis for effective placement of adjustable continence therapy (ACT®) balloons for treatment of female stress urinary incontinence by Ervin Kocjancic - Bruno Frea - Peter Robertson - Helen O'Connell

continence therapyTreatment of stress urinary incontinence is an imperfect science often met with varying degrees of over-correction leading to the eventual development of urgency, frequency and urge-incontinence, or under-correction resulting in inadequate control of the stress-induced urinary leakage.  [More]

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Case Report The use of triple vaginal ring pessaries in procidentia prior to total ProliftT procedure by Nader Gad

ringsLong-standing procidentia results in venous congestion, oedema, decubitus ulcers and infection. Preoperatively, the procidentia needs to be reduced for a sufficient period of time to allow healing of these ulcers. This management decreases intra-operative bleeding and complications. [More]

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Pelvic Floor Digest This Issue Pelvic Floor Digest read_pdf [245 kb]

pelvic floor digestThis section presents a small sample of the Pelvic Floor Digest, an online publication (www.pelvicfloordigest.org) that reproduces titles and abstracts from over 200 journals. The goal is to increase interest in all the compartments of the pelvic floor and to develop an interdisciplinary culture in the reader. [PDF]

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