and internal prolapse. Rectal prolapse is an anatomic abnormality and requires surgical resection. Numerous procedures have been described for the treatment of complete rectal prolapse, and these are classified as perineal or abdominal approaches. Perineal procedures such as the Delorme procedure, Altemeier operation (perineal rectosigmoidectomy), Thiersch procedure (anal encirclement), McCann ...

BACKGROUND The Perineal Assessment and Repair Longitudinal Study (PEARLS) is a national clinical quality improvement initiative designed to improve the assessment and management of perineal trauma. Perineal trauma affects around 85% of women who have a vaginal birth in the UK each year and millions more world-wide. Continuous suturing techniques compared with traditional interrupted methods are...

OBJECTIVE To review systematically techniques proposed to prevent perineal trauma during childbirth and meta-analyze the evidence of their efficacy from randomized controlled trials. DATA SOURCES MEDLINE (1966-1999), the Cochrane Library (1999 Issue 1), and the Cochrane Collaboration: Pregnancy and Childbirth Database (1995); and reference lists from articles identified. Search terms included...

BACKGROUND Fourth-degree perineal lacerations are an uncommon, unpredictable injury that family physicians may face. METHODS After a needs assessment and feasibility review, we developed goals, objectives, instructional tools, and a feedback survey for a curriculum using a novel model to simulate perineal laceration repair. RESULTS Fifty-six learners evaluated the session, expressing increa...

CASE REPORT A 19-year-old man presented to our outpatient clinic with a perineal mass and discomfort. Examination showed an empty and poorly developed left hemiscrotum. The contralateral testis was in its normal location in the right hemiscrotum (Figure 1). An oval-shaped soft mass was detected in the perineum measuring 4 × 5 × 6 cm. A clinical diagnosis of perineal ectopic testis was made. We ...

OBJECTIVE Spinal manipulation with high-velocity and low-amplitude (HVLA) manipulation is frequently used for the treatment of lumbopelvic pain; however, the effect on the pelvic floor has been poorly studied in the past. The objective of this study was to quantify the intravaginal pressure (IVP) and the basal perineal tonus (BPT), measured in terms of pressure, before and after the HVLA manipu...

BACKGROUND Approximately 85% of vaginal deliveries are accompanied by perineal trauma. The objective of this trial is to compare the incidence and degree of perineal trauma after primary delivery of the anterior compared with the posterior shoulder during vaginal birth. The hypothesis is that primary delivery of the posterior shoulder reduces the rate and degree of perineal trauma. METHODS/DE...

BACKGROUND Corticosteroids have anti-inflammatory, analgesic and antiemetic effects but causes severe perineal symptoms when given intravenously. Simultaneous administration of dexamethasone and fentanyl have been known to decrease the duration of perineal pain but its role in alleviating perineal pain has not been studied. Therefore, we hypothesized that fentanyl pretreatment could prevent the...

BACKGROUND The accurate assessment and appropriate repair of birth related perineal trauma require high levels of skill and competency, with evidence based guideline recommendations available to inform UK midwifery practice. Implementation of guideline recommendations could reduce maternal morbidity associated with perineal trauma, which is commonly reported and persistent, with potential to de...

background & aim: episiotomy is a common medical procedure for widening the perineum. in fact, perineal pain is the most common complaint after episiotomy. therefore, it is important to determine factors associated with postoperative pain following episiotomy in order to provide comfort for women after delivery. this study aimed to investigate factors associated with postoperative pain followin...