Perineal Swelling Research Articles

Reproductive parameters in the sooty mangabey (Cercocebus torquatus atys).

Data obtained over a 7.5 year period from a captive group of sooty mangabeys were analyzed to examine the relationship between demographic variables and reproductive events. Perineal swelling and reproductive data collected from 67 females contributed to the analyses. Sexual maturation, as marked by the onset of swelling cycles, was recorded at an average age of 36.4 ± 1.1 (mean ± SEM) months and first parturition at 56.5 ± 1.8 months, indicating a period of adolescent sterility of over 1 year. A total of 198 births were recorded, of which 165 (83.3%) were live births with infant survival to 30 days of age. Both parity and the duration of infant survival influenced interbirth interval, with the shortest interval observed in multiparous females with infants surviving less than 6 months (10.0 ± 0.5 months) and the longest in primiparous females with infants surviving more than 12 months (22.4 ± 1.2 months). Infant survival did not vary significantly according to the age class of the mother. Births and the onset of perineal swellings in young females showed a seasonal distribution, with swelling cycles and conceptions rarely occurring from April through September.

Short-day melatonin pattern advances puberty in seasonally breeding rhesus monkeys (Macaca mulatta).

Prepubertal, spring-born females (Group H: N = 5) living outdoors were given a daily injection of melatonin (0.70 microgram/kg, s.c.) late in the afternoon to produce a short-day melatonin pattern equivalent to a night of approximately 14 h. The dose of melatonin produced serum concentrations of melatonin which simply extended, within the 24 h day, the normal endogenous nighttime elevation (80-100 pg/ml). The study was started in March when the females were 23 months of age and continued through January. Parameters of sexual maturation for this group were compared to those of untreated, age-matched females (Group C: N = 5) which also lived outdoors under changing environmental conditions. Melatonin treatment significantly advanced age at first perineal swelling (23.9 +/- 0.5 vs 30.5 +/- 0.2 months) and menarche (26.2 +/- 0.9 vs 31.2 +/- 2.4 months). Since all of the females were spring-born, these events occurred earlier in the year in Group H females (swelling: April vs October; menarche: June vs November). Furthermore, 4/5 Group H females exhibited first ovulation in December at 31.8 +/- 0.3 months. None of the Group C females ovulated during their 2nd year, but all did so the next breeding season at 43.5 +/- 0.3 months. All first ovulations in females had luteal-phase progesterone concentrations elevated for at least 12 days with peaks greater than 3.0 ng/ml. Body weights were similar between groups until the post-menarchial interval when weight gain was greater in the melatonin-treated females. A similar pattern of group differences also was observed for serum concentrations of growth hormone and somatomedin-C. In addition, prolactin concentrations were seasonally elevated during the summer months in both groups, but concentrations fell to nadir values by August in Group H females and remained elevated until October in Group C animals. These results suggest that, in adolescent females housed outdoors, exposure to a short-day melatonin pattern permits sexual maturation to be initiated at an earlier age, allowing first ovulation to occur in the months immediately after menarche. A long-day melatonin pattern, typically experienced by females at this developmental age, may actually delay the initiation of maturational events until the subsequent fall months.

Dietary influences on growth and sexual maturation in premenarchial rhesus monkeys

The effect of a high-fat diet on growth, sexual maturation, and developmental changes in serum levels of estradiol (E2), growth hormone (GH), somatomedin-C (Sm-C), and insulin were examined in outdoor-housed premenarchial rhesus monkeys. From 16 to 32 months of age, females were fed either a high-fat diet ( HFD, N = 5) with 31% calories from fat or a control diet (commercial laboratory chow, N = 10) with 12% of the calories from fat. Maintenance on a HFD did not accelerate physical growth, as all animals exhibited similar increments in body weight, crown-rump length, and weight/height ratios. In contrast, the HFD group exhibited an earlier onset of perineal swelling and menarche despite lower body weights during that time. Moreover, 80% of the HFD animals exhibited an early first ovulation (31–32 months of age) compared with 40% of control animals. These reproductive changes were associated with significant differences in the endocrine profiles of HFD animals. Fasting serum levels of insulin were significantly elevated within 2 months of diet treatment and remained elevated throughout the study period. Levels of Sm-C were elevated relative to those of controls after 3 months of diet treatment, but not thereafter. Serum GH increased after 6 months on the HFD and, overall, concentrations were higher in HFD animals. A significant rise in E2 was observed after only 45 days on the HFD treatment. These concentrations did not differ from 18 to 21 months of age but again were elevated at 27 months in the HFD females. Since these endocrine and physical changes associated with reproductive physiology occurred in the absence of enhanced growth, these data suggest that a high-fat diet may influence the rate of sexual maturation through changes in certain metabolic factors which may act on the developing neuroendocrine system.

D-1 and D-2 receptor interactions: basic and clinical aspects

Idiopathic partial thrombosis (IPT) of the corpus cavernosum is a rare condition. The etiology is not fully understood; however, the presence of an either or not congenital web in these patients may contribute to the development of IPT.The aim of this study was to describe 18 new IPT cases and compare these with 38 cases found in the literature.A multicenter retrospective analysis was performed. Descriptive statistics are given.The main outcome measures used were clinical presentation, clinical and radiographical diagnostics, treatment and resolution of symptoms.Patients most frequently presented with perineal swelling (10/18; 56%) and pain (13/18; 72%), unilateral (12/18; 67%) or bilateral (4/18; 22%), and pain during erection (10/18; 72%). Penile curvature, dysuria or fever (each 1/18; 6%) were uncommon presenting symptoms. In our series, magnetic resonance imaging demonstrated a fibrous web in the corpus cavernosum in 100% of cases and was more bilaterally (11/18; 61%) than unilaterally (7/18; 39%) diagnosed. Cycling was found to be a provocative factor for IPT occurrence in patients at risk as 61% (11/18) of patients reported being a frequent cyclist with the episode of IPT occurring immediately after or during cycling activity in 8 out of 18 patients (8/18; 44%). In five centers, 15 patients were treated conservatively, the majority being treated with therapeutic doses of low molecular weight heparin and simultaneous anti-aggregant therapy. In one center, all three patients were treated with a surgical approach. Complete resolution of symptoms was noted in only 50% of cases.IPT is a condition that presents typically with perineal pain and swelling. Cycling is often seen as a provocative factor, while the presence of a fibrous web at the level of the crurocavernosal junction is the underlying disorder allowing for entrapment of blood in the crura. Conservative treatment provides a reasonably good outcome in most cases. For therapy resistant cases, surgery can be considered. Weyne E, Schillebeeckx C, Jamaer C, D'Hulst P, Bozzini G, Grunert R, d'Hondt F, Hoebeke P, Müller A, Van Renterghem K, Joniau S, Albersen M. Idiopathic partial thrombosis (IPT) of the corpus cavernosum; a hypothesis-generating case series and review of the literature. J Sex Med 2015;12:2118–2125.

Female perineal swelling and its effects on male sexual arousal: An apparent sexual releaser in the chacma baboon (Papio ursinus)

The function of the periodic perineal swelling that females of some primate species show in relation to their menstrual cycle has long puzzled many scientists. A role in female attractiveness was suspected, but fluctuations in female behaviors concomitant to these changes in female appearance have always prevented its assessment. By attaching a plastic reproduction of a fully swollen perineum to ovariectomized female chacma baboons, it has finally been demonstrated that the sexual swelling hasan important function in the sexual communication of this species. It induces sexual arousal in male conspecifics. The way the perineal swelling acts and other characteristic aspects of this feature appear to qualify it as a releaser for sexual behavior.

Effect of the Birth Chair on Duration of Second Stage Labor And Maternal Outcome

The effect of delivering in a birth chair on duration of second stage labor, perineal swelling, incidence of episiotomies, lacerations, hemorrhoids, and maternal blood loss was examined in a prospective quasi-experimental study. The sample consisted of 55 primiparous women, 37 to 41 weeks gestation, with normal pregnancy and labor; 22 delivered on a traditional delivery table (DT) and 33 in a birth chair (BC). Comparisons were made between groups for mean duration of second stage labor, mean time bearing down in the delivery room, mean maternal blood loss, frequency of instrument-assisted deliveries, frequency of episiotomies and lacerations, and frequency of perineal swelling and hemorrhoids. The two groups were statistically similar for weight of infant. No significant difference was found between groups for mean duration of second stage labor (BC M = 55 minutes, DT M = 43 minutes) or mean time bearing down (BC M = 60 minutes, DT M = 53 minutes). No difference was found in the amount of blood loss between the two groups as measured by the mean difference in the pre- and postdelivery hemoglobin (BC M change = 1.4 Gms, DT M change = 1.8 Gms). The lack of significant differences in blood loss may be due to the fact that the angle of the birth chair was lowered during or after delivery in 88% of the cases. The incidence of instrument-assisted deliveries (BC = 7, DT = 6), episiotomies (BC = 27, DT = 20), lacerations (BC = 17, DT = 5), and hemorrhoids (BC = 14, DT = 4) was similar between groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Cyclic perineal swelling during the intermenstrual intervals of captive female pygmy chimpanzees ( Pan paniscus)

The perineal swelling cycle and intermenstrual interval of pygmy chimpanzees ( Pan paniscus ) have not been well documented, and it is not clear that cither characteristic differs from those of common chimpanzees ( P. troglodytes ). Consequently, adult females in a breeding colony of P. paniscus were monitored for menses over four and one-half years, and the perineal swelling cycles were detailed for half that period. To test the hypothesis that there are no differences between the species of Pan in reproductive cyclicity of captive females, the results were compared with data collected from 22 captive P. troglodytes over an eight-year period by W. C. Young and R. M. Yerkes. The average duration of the intermenstrual interval of 49 days ( n =23; S.E.=2·9) for adult P. paniscus differed from an average of 34–36 days for adult P. troglodytes , but was similar to the 50-day interval of adolescent P. troglodytes . The pattern of the swelling cycle was different from any cycles exhibited by adult or adolescent P. troglodytes ; following the first sign of detumescence, the swelling retained significant tumescence for an average of 12 days. By altering slightly the definitions of each swelling phase, the durations of the phases subsequent to abrupt detumescence were found to resemble either the adult or the adolescent postswelling phases of P. troglodytes . Adult female P. paniscus exhibit marked swelling for approximately 75% of the intermenstrual interval in comparison to about 50% or less of the intervals exhibited by P. troglodytes . It follows that female P. paniscus are sexually attractive to males for a greater portion of the time, which may contribute to the differences in social organization reported for the two species in the wild. Aspects of the similarity in cyclicity between adult P. paniscus and adolescent P. troglodytes are congruous with interspecific morphometric analyses and the comparative anatomy of the female external genitalia, suggesting that some characteristics of P. paniscus may be neotenous with respect to P. troglodytes but not all distinctions can be accounted for by neoteny alone. The structural resemblance between the sexual swelling of female chimpanzees and the buttocks of human females suggests that female Australopithecinae may have been continuously attractive to males.

Clinical and Surgical Parameters in Dogs with Perineal Hernia Analysis of Results of Internal Obturator Transposition

The results of treatment of 31 dogs with perineal hernia by internal obturator muscle transposition were evaluated by comparing the clinical signs reported by the owner before surgery with those reported 11 or more months following surgery. The severity and frequency of pre‐ and postoperative clinical signs were categorized numerically, and composite scores were obtained for each dog. In addition, the dogs were examined 11 or more months following surgery. The presence or absence of an externally obvious perineal swelling was noted, and rectal examination was performed to detect rectal sacculation and the integrity of the pelvic diaphragm dorsal and ventral to a line drawn between the center of the anus and the ischiatic tuberosity. These results were correlated with the postoperative composite scores. Postoperative complications included wound infection (2), wound seroma (2), rectal prolapse (4), urinary incontinence (2), and flatus as a new postoperative problem (11). The postoperative composite score was significantly lower (improved function) following surgery. Dogs with worse signs preoperatively or bilateral perineal hernia benefited less from surgery. More dogs showed improvement when the operation was performed by experienced surgeons. Factors detected at follow‐up examination that correlated with more severe postoperative clinical signs were perineal swelling, absence of the ventral portion of the pelvic diaphragm, and rectal sacculation. The presence or absence of reformation of the dorsal aspect of the pelvic diaphragm did not correlate with postoperative clinical signs.

The antiestrogenic effect of clomiphene on perineal tumescence of the baboon in an in vitro fertilization program.

In a nonhuman primate in vitro fertilization program clomiphene citrate was used to superovulate the chacma baboon Papio ursinus. The antiestrogenic effect of clomiphene citrate was demonstrated locally on the perineal tumescence. In comparing the result of 50 spontaneous cycles and 18 clomiphene citrate-stimulated cycles, there was a statistical significant influence on cycle length and duration and degree of perineal swelling. This inhibitory effect on perineal tumescence of the baboon is another example of a local antiestrogenic effect of this drug. Furthermore, it nullified an important clinical parameter of ensuing ovulation.

The influence of male presence or absence on the reproductive cycle of celebes black ape females (Macaca nigra)

The effect of male presence on female menstrual cycles was studied in a group of 13 adult female and 3 adult male Celebes black apes (Macaca nigra) living in an outdoor enclosure. When males were absent, all cycling females had longer durations of maximal perineal swelling. Overall cycle length also appeared to be longer when males were absent, but there was no statistically significant increase. The data suggest that male absence results in a longer late follicular stage, perhaps indicating a delay in ovulation. Whereas these findings do imply that male presence may influence female macaque reproductive condition, it is acknowledged that this effect is much weaker than the demonstrated influence of female macaques on male reproductive state.

Ovulation detection and artificial insemination

Methods of detecting ovulation and conducting artificial insemination in great apes are reviewed and described. Ovulation time can be detected to some extent by measuring timing relative to such cyclic correlates as menstruation, perineal swelling, body temperature, viscosity of cervical mucus, and behavior (copulation, masturbation, aggressivity). The most precise methods are observation of ovarian morphology using laparoscopy or ultrasonography, but the most practical method for great apes is the use of recently developed rapid hemagglutination inhibition test for luteinizing hormone. Using this test, three chimpanzees and one gorilla have been successfully artificially inseminated. Artificial insemination in great apes involves collection of semen by automasturbation or rectal probe electro-ejaculation. Females are anesthetized and fractionated ejaculate is placed on the cervical os. Complicating factors include potential effect of anesthesia, variation in semen quality, frequency of AI required, and the apparent inherent infertility potential of great apes and humans.

Male chacma baboon ( Papio ursinus) sexual arousal: Mediation by visual cues from female conspecifics

(1) The changes in masturbatory behavior for nine adult males exposed to, but not allowed to contact, naturally cycling stimulus females were quite similar to the changes in perineal swelling shown by these females. (2) Serum testosterone concentrations of seven adult males exposed to a cycling stimulus female were related to their masturbatory behavior, with high levels occurring during the female's follicular phase. (3) Graded estradiol benzoate treatments of ovariectomized stimulus females revealed individual dosage levels below which there was no positive effect on the occurrence of visually stimulated male masturbation. (4) The present series of experiments documents the importance which visual cues have in the sexual interactions of this particular species.

Hereditary Angioneurotic Edema: An Unusual Case of Maternal Mortality

Abstract Hereditary angioneurotic edema is an autosomal dominant, nonallergic disorder characterized by recurrent attacks of brawny edema of the extremities, face, larynx, and genitalia [1] and biochemically by a reduction in the serum protein C1 esterase inhibitor, a factor which prevents the activation of the first component of the complement system [2]. Although most attacks are precipitated by trauma [3], there have been no previously reported cases in pregnancy during delivery or in the immediate postpartum period, despite obvious traumatic injury during the birth process. This report describes a patient who, following delivery, developed localized perineal swelling, which over 72 h progressed to generalized edema, terminating in irreversible shock.

Correlation of perineal swelling with serum ovarian hormone levels, vaginal cytology, and ovarian follicular development during the baboon reproductive cycle

Perineal swelling was correlated with changes in vaginal cytology and serum ovarian hormone levels and with development of the ovarian follicle. The average length of 66 menstrual cycles as seen in 12 mature baboons was 35.7±.66 days with a range of 25 to 47 days. Laparoscopic observations and photographic documentation of follicular development were made as early as 13 days prior to ovulation with the most rapid follicular maturation occurring 24 to 48 hours before ovulation. In 38.5% of the cycles ovulation occurred on the last day of maximal perineal tumescence with 26.9% of the ovulations occurring one day after initial detumescence. In 17.8% ovulations occurred two to five days prior to detumescence while the remaining 17.8% occurred two to three days following first observed detumescence. The mean progesterone level during the follicular phase was significantly less than that in the luteal phase, 1.6 and 6.7 ng/ml respectively (p<0.01). The level of estrogen detected during the periods of maximal tumescence was significantly higher (p<0.05) than that detected in the remainder of the cycle, 19.8 and 5.9 pg/ml respectively. Vaginal smears were stained, observed microscopically, and found to correlate with perineal swelling, hormone levels, and laparoscopic observations.

Selection of steroids for incorporation into silastic intrauterine devices

Progesterone, five synthetic progestins and one non-steroidal uterine relaxant were incorporated into silastic lUD's at levels at 5 and 10% total weight of the device in an effort to increase efficacy and decrease the rate of expulsion of the devices. Initial studies in rodents indicated that all compounds had some effect, the synthetic progestins being best. Five per cent devices did not inhibit mating while 10% did. The rate of release of four synthetic steroids was determined in rats, and that of medroxyprogesterone acetate in patas and rhesus monkeys as well. This latter steroid has been incorporated into IDD's (75–150 mg total dose) which have been used in women with very promising results. Two additional synthetic progestins, norgestrel and norethindrone, as well as Provera are being used in baboon IUD's with only Provera enhancing retention. The effect of daily microgram release rates of Provera on the menstrual cycle and perineal swelling is variable and reversible with removal of the device.

Extragonadal Endodermal Sinus Tumour of Teilum Report of Two Cases and Review of Literature

A 2-year perineal swelling of a 4-year-old girl and a 2-month swelling in the abdomen of a 1 year-old boy were found to be endodermal sinus tumours of Teilum. The gonads were normal in both. The histological appearance was typical with epithelial and stromal combinations and glomerulus-like structures called Schiller-Duval bodies. A brief review of the literature on the origin of these tumours is given. The girl is still alive but the boy died 2 days after laparotomy.

Baboon menstrual cycles affected by social environment.

Summary. The variation in the follicular phase of the menstrual cycles of seven parous female baboons was studied. The preliminary part of the follicular phase, before oestrus, was longer under conditions of psychosocial stress. Perineal swelling was increased when the normally groupliving female was placed in tactile isolation, and the colour of the swelling changed from bright pink to a pale grey-pink. The latter change was permanently reversed on return to the group. The former was temporarily reversed, but swellings continued to be abnormally large after a long succession of menstrual cycles in which pregnancy was prevented. There was some evidence that the swellings return to normal, after a pregnancy and lactation interval. The implications of these findings are discussed.

Perineal urethral diverticulum: complication of removal of ischium.

Removal of the ischium is the generally accepted method of treating ischial decubitus ulcer in patients with spinal cord injuries. Perineal urethral diverticulum has been observed in 22 of 48 patients after removal of the ischium (46 % ). It results from interference with the suspension of the triangular ligament and removal of the ischial tuberosities, thus exposing the pars diaphragmatica and the pars nuda urethrae to pressure. The diagnosis is made clinically (ischial sinus, perineal swelling, or ulcer), urethrocystographically, and urethroscopically. In the majority of cases treatment consists of introducing an indwelling catheter and of improving the general condition of the patient.

Variations in plasma protein mass during the menstrual cycle of the chacma baboon (Papio ursinus).

SUMMARY 1. Considerable fluctuations in plasma volume and protein mass occur in rhythm with the baboon's menstrual cycle. 2. During the follicular phase the mass of circulating albumin and globulin falls, while the fibrinogen mass increases. In the spayed female baboon oestrogen therapy leads to a similar reduction of albumin and globulin, but following ablation of the sexual skin this effect is greatly diminished. 3. During the initial 2–3 days of the luteal phase the circulating protein mass increases abruptly; the mass of protein simultaneously lost from the perineal swelling exceeds that which appears in the plasma. 4. Displacements in plasma protein of comparable extent have not previously been described in any animal maintained under physiological conditions. The available evidence indicates that these unusual fluctuations in the baboon are related to perineal hypertrophy and involution; the nature of this relationship is discussed.

A QUANTITATIVE STUDY OF THE INHIBITION OF THE OVARY AND OF THE TURGESCENT PERINEUM OF THE NORMAL BABOON PRODUCED BY A SINGLE INJECTION OF ESTRADIOL BENZOATE1

THE OBJECT OF THIS PAPER is to record the effects of single injections of varying amounts of estradiol on the behavior of the perineal (sexual) swelling and on the length of themenstrual cycle in the baboon (Papio porcarius) when given on the 8th to ioth day of the menstrual cycle. An assessment is made of the action of exogenous estrogen on the ovary as determined by the reaction of the perineal swelling and by the alteration in the length of the menstrual cycle.Atthe same time the possibility is considered of determining by an indirect approach, the amount of estrogen elaborated by the ovary on a particular day in the first part of the cycle. At the same time the mechanism whereby menstruation is postponed by the administration of estrogen is discussedin the light of the facts presented in this study. Attention is also drawn to the fact that whenever estrogen is used therapeutically in sufficient amounts, among its various effects it will also produce ovarian inhibition.