Search results for "Sphincter"
showing 10 items of 115 documents
High/low-volume center experience predicts outcome of AMS 800 in male stress incontinence: Results of a large middle European multicenter case series.
2020
AIM To analyze the influence of implantation volume of artificial sphincters (AMS 800) on outcome in a large central European multicenter cohort study. METHODS As part of the DOMINO (Debates on Male Incontinence) project, the surgical procedures and outcomes were retrospectively analyzed in a total of 473 patients who received an artificial sphincter (AMS 800) between 2010 and 2012. Clinics that implanted at least 10 AMS 800 per year were defined as high-volume centers. RESULTS Sixteen centers had a mean rate of 9.54 AMS 800/y of which five clinics were identified as high-volume centers. They implanted significantly more double cuffs (55% vs 12.1%; P < .001), used the perineal approach sign…
Surface Electromyography Reliably Records Electrophysiologically Evoked Internal Anal Sphincter Activity: A More Minimally Invasive Approach for Moni…
2016
<b><i>Background:</i></b> Even in the case of minimally invasive pelvic surgery, sparing of the autonomic nerve supply is a prerequisite for maintaining anal sphincter function. Internal anal sphincter (IAS) innervation could be electrophysiologically identified based on processed electromyographic (EMG) recordings with conventional bipolar needle electrodes (NE). This experimental study aimed for the development of a minimally invasive approach via intra-anal surface EMG for recordings of evoked IAS activity. <b><i>Methods:</i></b> Six male pigs underwent nerve-sparing low anterior rectal resection. Electric autonomic nerve stimulations were …
Use of Solovov-Badenoch principle in treating severe and recurrent vesico-urethral anastomosis stricture after radical retropubic prostatectomy: tech…
2012
What's known on the subject? and What does the study add? Many different approaches have been used to treat bladder neck strictures and urinary incontinence after radical prostatectomy in the past. Most techniques are highly invasive and carry a high risk of complications. The present study describes the use of the Solovov-Badenoch 'pull-through urethroplasty' as well as artificial urinary sphincter implantation.• To report our experience in the management of patients with combined urinary incontinence and stricture after radical prostatectomy with a two-step approach: urethroplasty with a 'pull-through' technique after the Solovov-Badenoch principle; and artificial urinary sphincter (AUS) …
Endoscopic papillary large balloon dilation in patients with large biliary stones and periampullary diverticula: Results of a multicentric series.
2018
Abstract Introduction Stone extraction represents the most frequent indication for endoscopic retrograde cholangiopancreatography (ERCP). Endoscopic papillary large balloon dilation (EPLBD) is a recent introduced approach consisting of an endoscopic papillary large balloon dilation following limited endoscopic sphyncterotomy (ES), which has been proven to be safe and effective for extraction of large common bile duct (CBD) stones. Peri-ampullary diverticula (PAD) are described in 10–20% of patients undergoing ERCP. Aim of our study is to evaluate efficacy and safety of EPLBD for the extraction of large biliary stones in patients with PAD. Methods The prospectively collected endoscopy databa…
Percutaneous antegrade electropapillotomy. Study in dogs.
1984
Antegrade electropapillotomy using the percutaneous transcystic approach was successfully performed in 11 of 16 dogs. When the intervention was effective, the pressure gradient between common bile duct and duodenum decreased from 6 to 1.3 mm Hg on average and returned to gradients slightly below the initial values after 4 weeks, owing to reactivation of the sphincter mechanism. Ineffective cutting, however, resulted in a temporary pressure rise. In one dog a papillary stenosis developed and was relieved by antegrade electrocutting. Irrespective of the success of the papillotomy, rises in levels of serum glutamine oxaloacetic and pyruvic transaminase, alkaline phosphatase, serum amylase and …
Management of intersphincteric abscesses.
2006
Objective Intersphincteric abscesses are relatively rare, and in some cases of upward extensions in the supralevator plane, can be difficult to manage. The aim of this study was to analyse the type of treatment used in these abscesses. Methods Twenty-one intersphincteric abscesses treated by endoanal drainage in our colorectal unit between 1992 and 2004 were reviewed from our database; location and extension of the abscess, type of treatment and recurrence rates and the use of endoanal ultrasound were studied. Results Ninety per cent of patients were male; 10 had a previous history of surgery for perianal abscess and suppuration (48%); 16 (76%) had a posterior location and five were ante…
Total mesorectal excision with intraoperative assessment of internal anal sphincter innervation provides new insights into neurogenic incontinence
2012
Background: The aim of this prospective study was to assess internal anal sphincter (IAS) innervation in patients undergoing total mesorectal excision (TME) by intraoperative neuromonitoring (IONM). Study Design: Fourteen patients underwent TME. IONM was carried out through pelvic splanchnic nerve stimulation under continuous electromyography of the IAS. Anorectal function was assessed with the digital rectal examination scoring system and a standardized questionnaire. Results: Nine of 11 patients who underwent low anterior resection had positive IONM results, with stimulation-induced increased IAS electromyographic amplitudes (median 0.23 V (interquartile range [IQR] 0.05, 0.56) vs median …
Selective pelvic autonomic nerve stimulation with simultaneous intraoperative monitoring of internal anal sphincter and bladder innervation.
2010
<i>Background:</i> Pelvic autonomic nerve preservation avoids postoperative functional disturbances. The aim of this feasibility study was to develop a neuromonitoring system with simultaneous intraoperative verification of internal anal sphincter (IAS) activity and intravesical pressure. <i>Methods:</i> 14 pigs underwent low anterior rectal resection. During intermittent bipolar electric stimulation of the inferior hypogastric plexus (IHP) and the pelvic splanchnic nerves (PSN), electromyographic signals of the IAS and manometry of the urinary bladder were observed simultaneously. <i>Results:</i> Stimulation of IHP and PSN as well as simultaneous intraop…
Intraoperative Monitoring of Bladder and Internal Anal Sphincter Innervation: A Predictor of Erectile Function following Low Anterior Rectal Resectio…
2013
<b><i>Background:</i></b> The objective was to investigate whether two-dimensional intraoperative neuromonitoring (IONM) of pelvic autonomic nerves has the potential to predict erectile function (EF) following surgery for rectal cancer. <b><i>Methods:</i></b> A consecutive series of 17 sexually active male rectal cancer patients undergoing IONM-based nerve-sparing low anterior rectal resection were evaluated prospectively. IONM was performed by electric stimulation of the pelvic splanchnic nerves with concomitant electromyography of the internal anal sphincter and cystomanometry. Sexual function was assessed using a validated questionnaire. &l…
Fistulectomy and sphincteric reconstruction for complex cryptoglandular fistulas
2009
Objective Complex anal fistulas (CFs) are difficult to treat. Endoanal advancement flap (EAF) is one of the standard treatment options for such clinical conditions. Immediate sphincter repair after fistulectomy (ISR) is not commonly performed because of the fear of causing postoperative incontinence. The objective of this study was to compare the results of both techniques. Method We retrospectively analysed a prospectively entered database composed of 146 patients (112 M; 34 F), undergoing operations for CF of cryptoglandular origin. The patients were divided in two groups: Group A: (EAF); n = 71 patients; Group B: (ISR); n = 75 patients. Results Forty-two fistulas (28.7%) were recurren…