hemorrhoidectomy is the treatment of choice for patients with third or fourth-degree hemorrhoids. although the majority of surgeons believe that surgical hemorrhoidectomy is the most effective approach with excellent results in the management of hemorrhoid disease, but hemorrhoidectomy is not a simple procedure. one of the complications of this surgery is an injury to anal sphincters that can l...

BACKGROUND Women with an obstetric anal sphincter injury are concerned about the risk of recurrent obstetric anal sphincter injury in their second pregnancy. Existing studies have failed to clarify whether the recurrence of obstetric anal sphincter injury affects the risk of anal and fecal incontinence at long-term follow-up. OBJECTIVE The objective of the study was to evaluate whether recurr...

Avoiding obstetrical injury to the anal sphincter is the single biggest factor in preventing anal incontinence among women. Any form of instrument delivery has consistently been noted to increase the risk of obstetric anal sphincter injury and altered fecal continence by between 2- and 7-fold. Routine episiotomy is not recommended. Episiotomy use should be restricted to situations where it dire...

Injury to the perineum, whether from episiotomy or spontaneous laceration, may result in loss of vaginal or rectal tone and/or anal incontinence. External anal sphincter defects can be identifi ed by endoanal ultrasound in 20% to 53% of women after normal vaginal delivery, a possible risk factor for anal incontinence that will be subsequently reported in 4% to 50% of cases. Flatal incontinence ...

OBJECTIVE To estimate the association between maternal obesity and risk of three different degrees of severity of obstetric anal sphincter injury. METHODS The study population consisted of 436,482 primiparous women with singleton term vaginal cephalic births between 1998 and 2011 identified in the Swedish Medical Birth Registry. Women were grouped into six categories of BMI. BMI 18.5-24.9 was...

The question is whether the urethral sphincter may be reconstructed after longitudinal injury similar to anal sphincter injuries. Analogue to obstetric, anal sphincter repair, an approximation repair of the sphincter may be feasible. An overlap repair is possible in anal sphincter repair, but because of the little tissue available in the urethral sphincter this is not an option. We describe thr...

Obstetric trauma following childbirth is the primary cause of faecal incontinence in women. Injury to the anal sphincter complex is common: it has been clinically diagnosed in 0.4–2.5% of vaginal deliveries involving a mediolateral episiotomy and in up to 19% of cases of midline episiotomy. Studies using endoanal ultrasound have reported occult anal sphincter injury in up to 35% of women after ...

Perineal injury sustained during childbirth is a major aetiological factor in the development of perineal pain, sexual dysfunction, prolapse and disturbance in bowel and bladder function. Preferential use of the vacuum extractor, restricting the use of episiotomy, repair of anal sphincter rupture by a trained doctor and selective caesarean section in these women can be beneficial in preventing ...

Hypothesis / aims of study We have previously optimized electrical stimulation (ES) parameters for up-regulation of mesenchymal stem cell (MSC) homing cytokines in the anal sphincter in a rat model. Our hypothesis is that low grade ES acts as a conditioning injury which upregulates homing cytokines that attract and retain MSC at the the area of previous injury thereby stimulating regeneration. ...