Background. Total laparoscopic hysterectomy (TLH) causes various types of postoperative pain, and the pain pattern has not been evaluated in detail to date. This prospective observational study investigated the types of postoperative pain, intensity in the course of time, and pain characteristics during the first postoperative 72 hr after TLH. Methods. Sixty four female patients undergoing TLH ...

The ganglion impar is an unpaired sympathetic structure located at the level of the sacrococcygeal joint. Blockade of this structure has been utilised to treat chronic perineal pain. Methods to achieve this block often involve the use of fluoroscopy which is associated with radiation exposure of staff involved in providing these procedures. We rep...

Letters NicoraNdil as a cause of periNeal ulceratioN. editor, We report a case of extensive perineal ulceration that healed spontaneously on discontinuation of nicorandil therapy, avoiding major perineal reconstructive surgery. We note a previous report of penile ulceration related to nicorandil therapy in this journal and wish to remind readers to consider nicorandil as a causative agent for a...

Aim: To determine the intraoperative Ramsay sedation score after dexmedetomidine infusion in patients undergoing perineal surgery. Study design: Descriptive study. Place and duration of study: Department Anaesthesia, JPMC, Karachi from 13th February 2021 to August 2021. Methodology: One hundred seventy four who met diagnostic criteria were enrolled. Results: The mean age was 46.51 years with st...

BACKGROUND There is no sufficiently validated therapy for chronic pelvic pain syndrome (CPPS). OBJECTIVE To investigate the effects of extracorporeal shock wave therapy (ESWT) in 60 patients suffering from CPPS. DESIGN, SETTING, AND PARTICIPANTS Sixty patients suffering from CPPS for at least 3 mo were investigated in two groups. Both groups were treated four times (once per week), each by ...

Cauda equina syndrome (CES) is a rare entity presenting with low back pain, unilateral or bilateral sciatica, motor weakness of lower extremities, sensory disturbance in the perineal area, and urinary and/or faecal incontinence. Those symptoms are secondary to compression of the cauda equina. If not recognized, CES can lead to irreversible disabilities. We report the case of a 77-year-old lady ...

BACKGROUND Severe perineal trauma occurs in 0.5-10% of vaginal births and can result in significant morbidity including pain, dyspareunia and faecal incontinence. The aim of this study is to determine the risk of recurrence, subsequent mode of birth and morbidity for women who experienced severe perineal trauma during their first birth in New South Wales (NSW) between 2000 - 2008. METHOD All ...