Editorial Editorial: Future
Directions
This
edition of Pelviperineology is the final edition of Volume 26 and is the Previous Issueof our first year in English. We have seen a steady growth in interest
in the journal with 4 international societies currently negotiating to collaborate
with Pelviperineology and produce the journal in their region. Pelviperineology
is printed in the same format around the world and in some countries is accompanied
by a local language edition or a newsletter. [More]
Full Text 
Pdf
This
edition of Pelviperineology is the final edition of Volume 26 and is the Previous Issueof our first year in English. We have seen a steady growth in interest
in the journal with 4 international societies currently negotiating to collaborate
with Pelviperineology and produce the journal in their region. Pelviperineology
is printed in the same format around the world and in some countries is accompanied
by a local language edition or a newsletter. [More] Full Text Pdf Original
ArticleThe
clinical role of the gracilis muscle: an example of multidisciplinary collaboration
by Enrico Vigato et al.
Gracilis muscle is widely used in reconstructive surgery, either
as a pedicled flap or as a free microsurgical flap. Both pedicled and free
flaps can be muscular or musculocutaneos (the so- called “composite
flaps”). As a pedicled flap, gracilis muscle can be used in perineal
and vaginal reconstruction, after oncological surgery, in the treatment
of recurrent anovaginal and rectovaginal fistulas as well in the
coverage of the neurovascular bundle after vascular surgery. [More]
Full Text Pdf
Gracilis muscle is widely used in reconstructive surgery, either
as a pedicled flap or as a free microsurgical flap. Both pedicled and free
flaps can be muscular or musculocutaneos (the so- called “composite
flaps”). As a pedicled flap, gracilis muscle can be used in perineal
and vaginal reconstruction, after oncological surgery, in the treatment
of recurrent anovaginal and rectovaginal fistulas as well in the
coverage of the neurovascular bundle after vascular surgery. [More] Full Text Pdf
Case Report
Neurilemoma (Schwannoma) of the ischiorectal fossa: a case report and a brief
review of the relevant pathology
by Johann Coetzee - Amanda De Beer
A
case of a primary neurilemoma of the ischiorectal space is described. The ischiorectal
fossa is a pelvic anatomic space, which until recently received scanty attention
in medical training programmes. With the advent of new surgical techniques
in reconstructive pelvic surgery, for example both the trans-obturator route
for sub-urethral slings and the passage of trocars for the posterior placement
of mesh supports in posterior prolapse, knowledge of the anatomy and pathology
of this space has assumed more importance. [More]
Full Text Pdf
A
case of a primary neurilemoma of the ischiorectal space is described. The ischiorectal
fossa is a pelvic anatomic space, which until recently received scanty attention
in medical training programmes. With the advent of new surgical techniques
in reconstructive pelvic surgery, for example both the trans-obturator route
for sub-urethral slings and the passage of trocars for the posterior placement
of mesh supports in posterior prolapse, knowledge of the anatomy and pathology
of this space has assumed more importance. [More] Full Text Pdf Original
ArticlePreliminary
retrospective case series study of the outcome of Prolift™ technique
in thirty women with pelvic organ prolapse including its effect
on stress urinary incontinence by Nader Gad, Maaike Moller
Pelvic
organ prolapse (POP) and associated stress urinary incontinence (SUI)
is a major health care problem. It is estimated that 50% of parous
women lose pelvic support and an American woman has a 11.1% lifetime
risk of undergoing an operation for pelvic floor support. An ageing
population is likely to increase the prevelance of POP and DeLancey
describes this anticipated increasing health burden as a “hidden
epidemic”. [More]
Full Text Pdf
Pelvic
organ prolapse (POP) and associated stress urinary incontinence (SUI)
is a major health care problem. It is estimated that 50% of parous
women lose pelvic support and an American woman has a 11.1% lifetime
risk of undergoing an operation for pelvic floor support. An ageing
population is likely to increase the prevelance of POP and DeLancey
describes this anticipated increasing health burden as a “hidden
epidemic”. [More] Full Text Pdf Review Role
of enterocele in obstructed defecation syndrome: proposal of a new radiological
and surgical classification by Claudio Morandi - Beatrice
Breveglieri - Claudio Moratti - Luca Verganti - Pietro Torricelli
Obstructed
defecation syndrome (ODS) is clinically defined as a prolonged (more than 6
months) history of difficult rectal evacuation, including excessive straining,
feeling of incomplete evacuation or inability to evacuate without digitation.
It is usually related to a functional disorder and it occurs most exclusively
in females. Many authors have reported an incidence of enterocele from 19%
to 35% in patients with Obstructed defecation syndrome. However, the role of
enterocele (defined as prolapse of the small bowel into the rectogenital space)
in this syndrome is still controversial. [More]
Full Text Pdf
Obstructed
defecation syndrome (ODS) is clinically defined as a prolonged (more than 6
months) history of difficult rectal evacuation, including excessive straining,
feeling of incomplete evacuation or inability to evacuate without digitation.
It is usually related to a functional disorder and it occurs most exclusively
in females. Many authors have reported an incidence of enterocele from 19%
to 35% in patients with Obstructed defecation syndrome. However, the role of
enterocele (defined as prolapse of the small bowel into the rectogenital space)
in this syndrome is still controversial. [More] Full Text PdfRetrospective
Review The
impact of birth history on pelvic floor function: a retrospective assessment
of 10,125 patients by Vito Leanza, Stefano Dati, Giovanni Pisapia
Cioffi, Manuela Accardi
The
pelvic floor is a network of muscles, ligaments and tissues that act like a
hammock to support the organs of the pelvis: uterus, bladder, and rectum. If
the muscles become weak or the ligaments or tissues are stretched or damaged,
the pelvic organs may fall down and protrude into the wall of the vagina. The
result is prolapse, urinary incontinence and reduced sexual response. It is
well known that pelvic floor disorders usually result from a combination of
factors. Pregnancy and vaginal delivery (VD) may weaken or stretch some of
the supporting structures. Pelvic floor disorders are common among women who
have had several vaginal deliveries, and the risk may increase with each delivery. [More]
Full Text Pdf
The
pelvic floor is a network of muscles, ligaments and tissues that act like a
hammock to support the organs of the pelvis: uterus, bladder, and rectum. If
the muscles become weak or the ligaments or tissues are stretched or damaged,
the pelvic organs may fall down and protrude into the wall of the vagina. The
result is prolapse, urinary incontinence and reduced sexual response. It is
well known that pelvic floor disorders usually result from a combination of
factors. Pregnancy and vaginal delivery (VD) may weaken or stretch some of
the supporting structures. Pelvic floor disorders are common among women who
have had several vaginal deliveries, and the risk may increase with each delivery. [More] Full Text Pdf Original ArticleSurgical
complications in coloproctology: a scoring system by Fabio
Gay - Pietro Crispino
Symptomatic
anorectal diseases frequently present to surgical outpatient departments and
many patients with these symptoms undergo surgical treatments. Recent studies
have demonstrated that a better understanding of the pathophysiology of anorectal
diseases and use of some recently introduced diagnostic tools can lead to better
choice of surgery for specific cases. In clinical practice the choice of a
specific surgical technique is based on the pre-operative assessment. [More]
Full Text Pdf
Symptomatic
anorectal diseases frequently present to surgical outpatient departments and
many patients with these symptoms undergo surgical treatments. Recent studies
have demonstrated that a better understanding of the pathophysiology of anorectal
diseases and use of some recently introduced diagnostic tools can lead to better
choice of surgery for specific cases. In clinical practice the choice of a
specific surgical technique is based on the pre-operative assessment. [More] Full Text Pdf Case
ReportPrepubic
sling in curing non-stress leakage following complete cure of stress
incontinence by a midurethral sling by Peter Petros - Peter
Richardson
A
46 year old woman with Von Willebrand’s disease gave a history
of urodynamically diagnosed severe stress incontinence (SI) cured initially
with a tension-free (monofilament) retropubic midurethral sling in August
2002. The patient was completely cured for almost 2 years. She presented
in late 2005 with a history of gradually worsening SI, continuous leaking,
no urgency, and no evidence of overactive bladder (OAB) on urodynamic
testing. On transperineal ultrasound, it was evident that the mesh tape
was pulling open the posterior urethral wall on straining. [More]
Full Text Pdf
A
46 year old woman with Von Willebrand’s disease gave a history
of urodynamically diagnosed severe stress incontinence (SI) cured initially
with a tension-free (monofilament) retropubic midurethral sling in August
2002. The patient was completely cured for almost 2 years. She presented
in late 2005 with a history of gradually worsening SI, continuous leaking,
no urgency, and no evidence of overactive bladder (OAB) on urodynamic
testing. On transperineal ultrasound, it was evident that the mesh tape
was pulling open the posterior urethral wall on straining. [More] Full Text Pdf Original ArticleThe
effect of suture material on outcomes of surgery for pelvic organ prolapse by
Howard B. Goldstein - Babak Vakili - Nicholas Franco - Karolynn T.
Echols - Ralph R. Chesson
Surgery
for pelvic organ prolapse (POP) is very common with 11% of women requiring
surgery at least once in their life. With dozens of different procedures being
performed and more being developed all the time, attempts are being made to
find the most durable procedure. Unfortunately fail- ure rates can be as high
as 63% after surgery for prolapse. While most studies investigating surgical
outcomes have focused on studying the actual procedures, there is very little
information assessing technique. [More]
Full Text Pdf
Surgery
for pelvic organ prolapse (POP) is very common with 11% of women requiring
surgery at least once in their life. With dozens of different procedures being
performed and more being developed all the time, attempts are being made to
find the most durable procedure. Unfortunately fail- ure rates can be as high
as 63% after surgery for prolapse. While most studies investigating surgical
outcomes have focused on studying the actual procedures, there is very little
information assessing technique. [More] Full Text Pdf Original ArticlePruritus
ani: etiologic and causative factors in 94 adult patients by
Cleto Veller Fornasa - Alessandra Trento - Gianni Bezze
A
chronic itch around the anal area is called pruritus ani. It can be due to
a localised dermatitis (caused by faeces, sweat, or moisture), viral, bacterial
and fungal infection, metabolic or systemic diseases (lymphoma, iron deficiency
anaemia, hyperthyroidism, diabetes, etc.), skin conditions (psoriasis, contact
dermatitis, atopic dermatitis, or lichen planus), anal fissure, haemorrhoids,
threadworms, irritants (soaps, perfumes, or creams), some foods (grapes, or
tomatoes), some drugs (laxatives, anaesthetic agents, antibiotics), or a carcinoma
of the anus. [More]
Full Text Pdf
A
chronic itch around the anal area is called pruritus ani. It can be due to
a localised dermatitis (caused by faeces, sweat, or moisture), viral, bacterial
and fungal infection, metabolic or systemic diseases (lymphoma, iron deficiency
anaemia, hyperthyroidism, diabetes, etc.), skin conditions (psoriasis, contact
dermatitis, atopic dermatitis, or lichen planus), anal fissure, haemorrhoids,
threadworms, irritants (soaps, perfumes, or creams), some foods (grapes, or
tomatoes), some drugs (laxatives, anaesthetic agents, antibiotics), or a carcinoma
of the anus. [More] Full Text Pdf Letter to EditorSTARR
Procedure for the treatment of outlet obstruction syndrome by
Mario Pescatori
Dear
Editor, I read with interest the paper by Reboa et al. reporting good results
after STARR procedure in a group of constipated patients. Less satisfactory
results were achieved using the stapled transanal mucosectomy, first described
by Pescatori, Favetta, Dedola and Orsini in Techniques in Coloproctology in
1997 for the treatment of rectal internal mucosal prolapse (and not, as stated
by the authors, by Longo, who instead reported it for the cure of hemorrhoids
one year later). [More]
Full Text Pdf
Dear
Editor, I read with interest the paper by Reboa et al. reporting good results
after STARR procedure in a group of constipated patients. Less satisfactory
results were achieved using the stapled transanal mucosectomy, first described
by Pescatori, Favetta, Dedola and Orsini in Techniques in Coloproctology in
1997 for the treatment of rectal internal mucosal prolapse (and not, as stated
by the authors, by Longo, who instead reported it for the cure of hemorrhoids
one year later). [More] Full Text Pdf Letter to EditorAhmed
Shafik (1933-2007) by
Luca Amadio
Dear
Sir, I was never able to meet Prof. Ahmed Shafik in person. In comparison to
others expressing their feelings following his death I cannot say that I have
worked with him, nor was I one of his students. My link with Professor Shafik
is through his scientific papers. My first contact took place as a resident
in Surgery when I studied his paper on the pathogenesis of anal abscess and
fistula. The original and more complex Shafik theory of anorectal sinus was
in contrast to the cryptic glandular and the perineal infection theories of
Eisenhammer and Goligher. The originality of his theory was the distinguishing
mark of a sharp, unique and sometimes unconventional mind. The contribution
of Professor Shafik to pelvic floor medicine was immense. Over 500 peer reviewed
articles are listed in Pub Med.. [More]
Full Text Pdf
Dear
Sir, I was never able to meet Prof. Ahmed Shafik in person. In comparison to
others expressing their feelings following his death I cannot say that I have
worked with him, nor was I one of his students. My link with Professor Shafik
is through his scientific papers. My first contact took place as a resident
in Surgery when I studied his paper on the pathogenesis of anal abscess and
fistula. The original and more complex Shafik theory of anorectal sinus was
in contrast to the cryptic glandular and the perineal infection theories of
Eisenhammer and Goligher. The originality of his theory was the distinguishing
mark of a sharp, unique and sometimes unconventional mind. The contribution
of Professor Shafik to pelvic floor medicine was immense. Over 500 peer reviewed
articles are listed in Pub Med.. [More] Full Text Pdf EditorialPERINEOLOGY… THE
STORY BEHIND THE CONCEPT by Jacques Beco - Jack Mouchel
The
development during the early eighties of the procedure we later called the
Mini-Vaginal-Tape (MVT) was the frst step on the road to the concept of Perineology.
Development of vaginal surgery for hysterectomy and genital prolapse during
the late seventies and the early eighties led inevitably to the need for an
efficient vaginal procedure for the cure of the stress urinary incontinence
which proved to be frequent in this kind of patients .Apart from the Marion-Kelly
technique, no vaginal procedure was at that time regarded as effcacious enough
and the “Gold Standard” for the cure of this urinary dysfunction
was then (and remained until the late nineties) the Goebbel-Stoeckel and Burch
procedures. [More]
Full Text Pdf
The
development during the early eighties of the procedure we later called the
Mini-Vaginal-Tape (MVT) was the frst step on the road to the concept of Perineology.
Development of vaginal surgery for hysterectomy and genital prolapse during
the late seventies and the early eighties led inevitably to the need for an
efficient vaginal procedure for the cure of the stress urinary incontinence
which proved to be frequent in this kind of patients .Apart from the Marion-Kelly
technique, no vaginal procedure was at that time regarded as effcacious enough
and the “Gold Standard” for the cure of this urinary dysfunction
was then (and remained until the late nineties) the Goebbel-Stoeckel and Burch
procedures. [More] Full Text Pdf Pelvic Floor
Digest December Issue
Pelvic Floor Digest [362 kb]
This
section presents a small sample of the Pelvic Floor Digest (December 2007),
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]
Pdf
[362 kb]This
section presents a small sample of the Pelvic Floor Digest (December 2007),
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] Pdf