Anus In Female Research Articles

Trans-sphincteric anorectoplasty for rectovestibular fistula

Abstract:
 Introduction:
 Imperforate anus with rectovestibular fistula is the most common form of the imperforate anus in females and is an intermediate type of this disease, which is treated surgically(2). Generally, patients with vestibular fistulas have good functional results when treated by fistula transposition (8).
 Materials and methods:
 This was a prospective study did from January 2016 to January 2017. We included all female with age range from (25 days -12years old) diagnosed as a rectovestibular fistula (RVF) operated by single stage TSARP, at pediatric surgery units of Assiut and Aswan university hospitals. The functional results, cosmetic appearance and postoperative complication for each case after treatment were evaluated in patients for 3-6 months.
 
 Results:
 The total numbers of cases are 22 cases from rural areas of Upper Egypt, (36.36%) of patient's fathers and mothers are relatives and have associated anomalies. (50%) of cases are complaining of recurrent attack of constipation. (45.5%) of cases developed wound infection at the neoanal site. 7 cases are now more than 3years old, 6 of those 7 cases achieved voluntary bowel control and toilet trained and have good (4-5 points) wing spread score. One case less than 3 years old also achieved voluntary bowel control and toilet trained and has good (5 points) wing spread score.
 Conclusion:
 Trans-sphincter anorectoplasty (TSARP) is easy to perform with reasonable operative time, good cosmetic and functional outcome. Separation of the rectum from the posterior wall of the vagina is the most delicate step of the operation, takes place under direct vision. Constipation is an essential problem in patients that can be managed by laxatives. Meticulous post-operative wound care is essential.

Morphological and molecular characterization of two isolates of Paratrichodorus porosus from Shenzhen, China

Abstract Studies were conducted to characterize morphological and molecular profiles of two isolates of Paratrichodorus porosus (SZ1 and SZ2) which were recovered from Acacia mangium in Tianxinshan and Gleichenia linearis in Yangmeikeng environmental monitoring sites in Shenzhen, China, respectively. Analysis of morphometric, morphological and molecular characters revealed these two Shenzhen isolates are identical to P. porosus. Measurements of both study isolates lie within the ranges for P. porosus. It is typologically characterized by possessing a clearly swollen body cuticle after fixation, an onchiostyle ventrally curved, 46–58 μm long, a pharyngeal bulb usually with a well developed anterior-dorsal intestinal overlap, a secretoryexcretory pore opening between the nerve ring and anterior end of pharyngeal bulb, 90–110 μm from the anterior end, a reproductive system with didelphic, amphidelphic, without spermathecae, a pore-like vulva in ventral view and occupying 52.0 %–59.5 % of total body length from anterior end, a short and barrel-shaped vagina with small sclerotizations, a pair of ventromedian advulvar body pores located prevulvar and postvulvar, a rounded tail and a subterminal anus in females. The sequence analysis based on partial rDNA 18S gene and 28S D2/D3 expansion segment confirm its identity as P. porosus. This is the first report of P. porosus associated with A. mangium and G. linearis.

Anal transposition (trans-sphincteric ano-rectoplasty) for recto-vestibular fistula

Background: Imperforate anus with recto-vestibular fistula is the most common form of imperforate anus in females and is an intermediate type of this disease, which is treated surgically. The current study aimed to compare three techniques used for the treatment of imperforate anus with recto-vestibular fistula. Materials and Methods: Fifty-four cases of imperforate anus with recto-vestibular fistula were managed using three main approaches: posterior sagittal ano-rectoplasty, anterior sagittal ano-rectoplasty, and the anal transposition or trans-sphincteric ano-rectoplasty (TSARP). The functional results and cosmetic appearance for each case after treatment were evaluated in patients above 3 years of age (43 cases). Results: The functional outcomes were good in all treatment groups; however, the better cosmetic results were evident in the group treated using TSARP, a technique, which preserves the skin bridge between the new anus and the posterior fourchette, does not disturb the perineal body, and avoids division of the levator muscles. In this group, a continence rate of 100% but a higher constipation rate (41%) than in the other groups was recorded. Conclusion: TSARP is recommended for imperforate anus with recto-vestibular fistula.

The surgical treatment of H-fistula with normal anus in girls

The surgical treatment of children with H-fistula is one of the understudied problems of the present day, especially regarding its high rates of complications. The surgical technique of bringing down the anterior wall of rectum in clinical practice allows us in reducing the rate of H-fistula recurrences. The results of our studies have shown the substantial advantages of the suggested method compared to the traditional ones. The aim of this work was the improvement of methods of surgical correction of H-fistulas in female children with normal anus. From 1994 to 2008, 28 children have been operated for H-fistulas with normal anus in our elective surgery department. The first group consisted of 8 children who were operated for invaginated fistula extirpation. The second group of 2 children underwent a dissection and fistula suture through transperineal access. The third group consisted of 18 patients who were operated for an anterior anorectoplasty with fistula extirpation and pull-through of the anterior wall of the rectum outside the anal canal. The patients age varied from 3 to 8 years. The diagnoses were based on clinical manifestation, X-ray examination, endoscopy and histological tests. In 6 patients, from the first group soiling and gas production through the surgical wound were observed; in 5 of them, fistulas recurred, in 1 patient the fistula was closed with diverticulum of rectum. Only 2 patients had satisfactory results. All patients from the second group with rectovaginal fistulas had recurrences. The 18 patients from the third group had not recurred. In 5 children, fecal soiling disappeared after conservative rehabilitation measures. H-fistula with normal anus in females is a complicated malformation demanding a surgical correction in specialized proctologic clinics. The method of anterior anorectoplasty with fistula extirpation and pull-through of the anterior wall of the rectum is pathogenically valid and is the method of choice in treatment of H-fistula in children.

New Pudicinae (Trichostrongylina, Heligmosomoidea), Pudica ctenomydis n. sp. parasite of Ctenomys talarum (Rodentia: Octodontidae) from Argentina

A total of 138 nematodes were found in the small intestine of Ctenomys talarum (Octodontidae) from Mar de Cobo, Argentina. A new nematode species, Pudica ctenomydis n. sp., is described. The new species more closely resembles P. pujoli Durette-Desset, 1990, parasite of Microcavia niata Thomas, from Bolivia. It can be distinguished from P. pujoli by the number of ridges and characteristics of the synlophe, the spicular morphology, differences in length between rays 9 and 10, and by the presence of a symmetrical caudal bursa and a cuticular expansion surrounding the body between vulva and anus in females.

Imperforate anus in females: Frequency of genital tract involvement, incidence of associated anomalies, and functional outcome

Of 162 female patients with imperforate anus, 21% had a noncommunicating and 79% a communicating anomaly of the rectum or anus. Associated anatomical abnormalities were found in the lower urinary tract (15%), upper urinary tract (25%), lower genital tract (27%), upper genital tract (35%), and additional organ systems (51%). Death occurred in 26 patients and in 19, this was attributed to the associated abnormalities. Functional outcome was assessed in those patients 13 years of age or older. Bowel function was normal or near normal in 85%, as was urinary and renal function. In 44% of patients evaluated, there was persistent vaginal abnormality or scarring and in 25%, this was severe enough to require future surgery.

Treatment of Congenital Rectal Fistulae Associated with Imperforate Anus in Females

SummaryThe results of perineal proctoplasty in 10 cases of congenital low rectal fistulas associated with imperforate anus in female babies have been presented. The technique of perineal proctoplasty has been outlined with emphasis on the steps which ensure a good result.

Single stage Anterior Sagittal Anorectoplasty (ASARP) for Anorectal Malformations with Vestibular Fistula and Perineal Ectopic Anus in Females: A New Approach

Introduction: Despite a better understanding of the embryology, anatomy of anorectal malformations and of the physiology of continence, the management of children born with imperforate anus continues to be a surgical challenge and is still fraught with numerous complications and often leads to less than perfect qualitative results. Pediatric patients with recto-vestibular fistula have good prognoses in terms of bowel function when properly treated. Aim & Objective: The study was designed to assess the surgical morbidity of single stage Anterior Sagittal Anorectoplasty (ASARP). Methodology: This prospective study was carried for a period of 26 months. It included a total of 48 female patients (aged 0 - 14 years) with diagnosis of Anorectal Malformations (ARM) with vestibular fistula or perineal ectopic anus. In ASARP, Patient in lithotomy position, the anterior portion of sphincter muscles were cut through a midline perineal skin incision, rectum was separated from the vagina & then rectum was pulled through the center of these muscles. The perineal body was reconstructed and the normal appearance of perineum was achieved. Results: Short-term surgical outcome was satisfactory in all cases. No one needed colostomy. Conclusion: Single-stage ASARP is a good approach in experience hands for ARM with vestibular fistula and perineal ectopic anus in females and thereby complications and time involved in staged procedures including colostomy can be avoided. Key words: Anterior sagittal anorectoplasty, anorectal malformations, perineal ectopic anus, vestibular fistula. DOI: 10.3126/jnps.v30i1.2458 Journal of Nepal Paediatric Society Vol.30(1) 2010 37-43

Two new mutations in the Syrian hamster.

THE Syrian hamster, Mesocricetus auratus, introduced to the laboratory by Adler and Theodor1 in 1931, is a golden-brown rodent with pale cream belly fur and two characteristic throat flashes. Melanic pigment darkens the skin of the ears and is present about the genitals in both sexes (in the region of the vulva and anus in females, and in the scrotum and spots on the prepuce in males). It is to be expected, as increasing numbers of hamsters are bred, that mutant types will appear. This note records the occurrence of two new mutations.