Repair Of Anal Sphincter Injuries Research Articles

Diagnostic capabilities of transperineal ultrasound (TPUS) to evaluate anal sphincter defect post obstetric anal sphincter injury (OASIS)? A systematic review

IntroductionEndoanal ultrasound (3D-EAUS) is the gold standard imaging investigation for evaluating the anal sphincter; unfortunately, it is not universally available in most obstetric units. This study aims to appraise the ability of transperineal ultrasound (TPUS) compared with 3D-EAUS as the gold standard to identify anal sphincter defects after primary repair of OASIS.MethodsA systematic search of major databases to identify diagnostic accuracy of 3D-TPUS in evaluating anal sphincter defects. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were designed for this systematic review. The risk of bias and applicability concerns were assessed using the QUADAS-2 tool. Our eligibility criteria are patients with a history of primary repair of anal sphincter injuries (OASIS). They were followed up after the primary repair to detect the anal sphincter defect using 3D-TPUS vs. 3D-EAUS as a gold standard.ResultsTwo eligible observational studies were included and assessed for risk of bias using the QUADAS-2 tool and showed a low risk of bias and a low risk of concerns. 3D-TPUS had various sensitivity to detect external anal sphincter defects in two studies; meanwhile, the specificity was around 67–70%. For detecting the internal anal sphincter defects, 3D-TPUS had low sensitivity but high specificity (93–94%).Conclusion3D-TPUS had various sensitivity to detect external anal sphincter defects and low sensitivity to detect internal anal sphincter defects. On the other hand, 3D-TPUS had low specificity for detecting external anal sphincter defects and high specificity for detecting internal anal sphincter defects.

Outcomes of Anal Sphincter Injury Repair; Minia University Hospital Experience Prospective Study

Outcomes of Anal Sphincter Injury Repair; Minia University Hospital Experience Prospective Study

08: Regenerative medicine approach to augment surgical repair of anal sphincter injuries: Injection of purified exosome product may improve anorectal manometry parameters and sphincter integrity

08: Regenerative medicine approach to augment surgical repair of anal sphincter injuries: Injection of purified exosome product may improve anorectal manometry parameters and sphincter integrity

Feasibility and benefits of the ewe as a model for vaginal surgery training.

The objective was to evaluate the ewe as an animal model for teaching and training in vaginal surgery. Twenty-nine postgraduate surgeons attended a training course on vaginal prolapse surgery. After a review of human and sheep anatomy, the participants performed transvaginal meshes, vaginal hysterectomy, SSLF (Richter), and OAS repair in ewes and human cadavers. Participants completed questionnaires on the whole course. Questionnaires showed the significant superiority of ewes over human cadavers for all items evaluated regarding surgical dissections. Only identification of the sacrospinous ligament and the spine were judged to be similar in ewes and human cadavers. Participants noticed that ewe model is appropriate for vaginal prolapse surgery training for resident and for postgraduate surgeons. Two vaginal hysterectomies were also performed. Operating time, surgery, and anatomy were nearly identical to that of humans. The same conclusions were made while performing sacrospinous ligament fixation (Richter) and obstetric anal sphincter injury repair. This series indicates that the ewe is a useful animal model for teaching vaginal surgery.

Impact d’un atelier de formation au diagnostic et à la réparation des lésions obstétricales du sphincter anal et de la muqueuse rectale sur les compétences des internes et chefs de clinique

To evaluate the impact of a training workshop on residents and senior registrar skill in repair of anal sphincter and rectal mucosae obstetrical injury.Residents and senior registrar practical and theoretical knowledge were evaluated by a questionnaire sent, using AGOF (association des gynécologues-obstétriciens en formation) mailing list. This questionnaire includes questions about epidemiology, risk factors and sutures types. Scores were compared according to the participation or not at the workshop.There were 106 residents or senior registrar (48.4%) in the workshop group and 113 (51.6%) in the control group. Scores were significantly higher in the workshop group than in the control group for theoretical knowledge (4.1 vs. 3.7), practical knowledge (17.6 vs. 15.9) and global scores (21.7 vs. 19.7). There was no difference according to the participation before or after the third residency semester. Residents global scores were statistically higher in the workshop group compared to the control group (21.8 vs. 19.5) but there was no significant difference between the senior registrar of the two group. Participants in the workshop group estimate themselves significantly more efficient than in the control group concerning anal sphincter injury repair and rectal mucosae repair.A training workshop seems to improve the theoretical and practical skill.4.

I111 SURGICAL OUTCOMES AND THE CLIENTS' SATISFACTION FOR RECONSTRUCTIVE SURGERY FOR FEMALE GENITAL MUTILATION

Results: The clients reported that they were accepted of the issue of reconstructive surgery. The majority were very satisfied (86%), the rest (14%) of the group were satisfied with the results of the surgery in regards the healing & its duration, shape of the vulva, disappearance of vaginal discharge and the regaining or starting of the sexual activity and the interest. Conclusion: This study confirmed that the reconstructive surgery for the female genital mutilation victims (RCFGM) can be performed to restore some of the genital anatomy with a high degree of clients’ acceptance and satisfaction. Lucky enough the study proves the clients’ refusal to perform FGM for their girls in the future, which gives an excellent chance for the health promotion and education initiative to stand against FGM. I112 CURRENT MANAGEMENT OF PERINEAL TRAUMA AFTER VAGINAL DELIVERY R. Fernando Over 60% of women suffer perineal trauma caused either by perineal tear or episiotomy following vaginal delivery. Perineal trauma sustained during childbirth is a major aetiological factor in the development of perineal pain, sexual dysfunction, pelvic organ prolapse, urinary and faecal incontinence. Preferential use of the vacuum extractor, restricting the use of episiotomy, perineal repair with continuous non locking polyglactin sutures, repair of anal sphincter injury by a trained doctor and selective caesarean section in these women has been shown to be beneficial in preventing complications. More focused training of midwives and doctors in perineal and anal sphincter anatomy and repair technique has also been shown to minimize the morbidity associated with inadequate repair and missed tears. At present there is limited evidence available to predict and prevent perineal trauma and how to manage subsequent pregnancy following anal sphincter injuries and further research need to be focused in these areas. I113

Moving towards a new year

Moving towards a new year