The Experts below are selected from a list of 285 Experts worldwide ranked by ideXlab platform
Torvid Kiserud - One of the best experts on this subject based on the ideXlab platform.
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three dimensional endoanal ultrasound assessment of the anal Sphincters during rest and squeeze
Acta Obstetricia et Gynecologica Scandinavica, 2008Co-Authors: Ingrid Petrikke Olsen, Kare Augensen, Tom Wilsgaard, Torvid KiserudAbstract:Background. Current ultrasound assessment of the anal sphincter is based on measurements during rest. However, active constriction plays a role in maintaining continence. Here we assess female anal dimensions during rest and squeeze. Methods. Thirty women were recruited for a cross-sectional endoanal ultrasound study after written consent according to an ethically approved protocol: nine 0-gravida, 10 with normal vaginal delivery, and 11 with complicated vaginal delivery (babies >4,500 g, operative vaginal delivery or perineal rupture). Endoanal three-dimensional (3D)-ultrasound volume was obtained during rest and squeeze. Length of anal canal and volume of the external and internal Sphincters were determined. Results. In the 0-gravida group, the mean anal canal at rest was 3.28 cm (SD: ±0.63) compared with 2.30 (±0.77) in those who had given birth (p =0.002). Correspondingly, the volume of the external sphincter was 7.61 cm3 (±2.63) versus 4.80 (±2.02) (p =0.004), and for the internal sphincter 2.63 (±1....
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three dimensional endoanal ultrasound assessment of the anal Sphincters reproducibility
Acta Obstetricia et Gynecologica Scandinavica, 2008Co-Authors: Ingrid Petrikke Olsen, Kare Augensen, Tom Wilsgaard, Torvid KiserudAbstract:Objective. Volume measurement of the anal sphincter can be a future method for assessing volume loss, muscle atrophy or laceration. Three-dimensional (3D) endoanal ultrasound is a technique for assessing the volume of the anal Sphincters, but the reproducibility of the method is scarcely known. Design. Cross-sectional, repeated measurements. Sample. Twenty women were recruited for the study after written consent according to an ethically approved protocol, nine 0-gravida and 11 with traumatic vaginal deliveries. Method. Endoanal 3D-ultrasound volume was obtained during rest and squeeze. The length of the anal canal and the volume of the external and internal Sphincters were determined by two observers. Observer 1 repeated the measurements three times for all 20 women, and observer 2 for the nine 0-gravida, and intra- and inter-observer variation was assessed. Results. During rest, the anal length measurement had intra-class correlation coefficients of 0.91 for observer 1 and 0.85 for observer 2. The limit...
Ingrid Petrikke Olsen - One of the best experts on this subject based on the ideXlab platform.
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three dimensional endoanal ultrasound assessment of the anal Sphincters during rest and squeeze
Acta Obstetricia et Gynecologica Scandinavica, 2008Co-Authors: Ingrid Petrikke Olsen, Kare Augensen, Tom Wilsgaard, Torvid KiserudAbstract:Background. Current ultrasound assessment of the anal sphincter is based on measurements during rest. However, active constriction plays a role in maintaining continence. Here we assess female anal dimensions during rest and squeeze. Methods. Thirty women were recruited for a cross-sectional endoanal ultrasound study after written consent according to an ethically approved protocol: nine 0-gravida, 10 with normal vaginal delivery, and 11 with complicated vaginal delivery (babies >4,500 g, operative vaginal delivery or perineal rupture). Endoanal three-dimensional (3D)-ultrasound volume was obtained during rest and squeeze. Length of anal canal and volume of the external and internal Sphincters were determined. Results. In the 0-gravida group, the mean anal canal at rest was 3.28 cm (SD: ±0.63) compared with 2.30 (±0.77) in those who had given birth (p =0.002). Correspondingly, the volume of the external sphincter was 7.61 cm3 (±2.63) versus 4.80 (±2.02) (p =0.004), and for the internal sphincter 2.63 (±1....
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three dimensional endoanal ultrasound assessment of the anal Sphincters reproducibility
Acta Obstetricia et Gynecologica Scandinavica, 2008Co-Authors: Ingrid Petrikke Olsen, Kare Augensen, Tom Wilsgaard, Torvid KiserudAbstract:Objective. Volume measurement of the anal sphincter can be a future method for assessing volume loss, muscle atrophy or laceration. Three-dimensional (3D) endoanal ultrasound is a technique for assessing the volume of the anal Sphincters, but the reproducibility of the method is scarcely known. Design. Cross-sectional, repeated measurements. Sample. Twenty women were recruited for the study after written consent according to an ethically approved protocol, nine 0-gravida and 11 with traumatic vaginal deliveries. Method. Endoanal 3D-ultrasound volume was obtained during rest and squeeze. The length of the anal canal and the volume of the external and internal Sphincters were determined by two observers. Observer 1 repeated the measurements three times for all 20 women, and observer 2 for the nine 0-gravida, and intra- and inter-observer variation was assessed. Results. During rest, the anal length measurement had intra-class correlation coefficients of 0.91 for observer 1 and 0.85 for observer 2. The limit...
Arianna Menciassi - One of the best experts on this subject based on the ideXlab platform.
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artificial Sphincters to manage urinary incontinence a review
Artificial Organs, 2018Co-Authors: Leonardo Marziale, Gioia Lucarini, Tommaso Mazzocchi, Emanuele Gruppioni, Simona Castellano, Angelo Davalli, Rinaldo Sacchetti, Donatella Pistolesi, Leonardo Ricotti, Arianna MenciassiAbstract:: Urinary incontinence affects more than 300 million people worldwide. The implantation of a medical device called an artificial urinary sphincter (AUS) is the gold standard treatment when conservative and minimally invasive therapies fail. In this article, the AUSs (extra-urethral and endo-urethral Sphincters) available on the market, both presented at the research level and filed as patents, are reviewed. The ability of the different solutions to effectively replace the natural sphincter are discussed, together with advantages and some possible side effects, such as tissue atrophy, overall invasiveness of the implant, and so forth. Finally, future research priorities are discussed for both endo-urethral and extra-urethral approaches considering key engineering aspects, such as materials, compression and closure mechanisms, and implantation methods, with the long-term aim of developing an effective, reliable, durable, and minimally invasive AUS capable of restoring a normal quality of life for incontinent patients.
Adil E Bharucha - One of the best experts on this subject based on the ideXlab platform.
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magnetic resonance imaging of anatomic and dynamic defects of the pelvic floor in defecatory disorders
The American Journal of Gastroenterology, 2003Co-Authors: Joel G Fletcher, Reed F Busse, Stephen J Riederer, David M Hough, Thomas M Gluecker, C M Harper, Adil E BharuchaAbstract:Abstract Objective Endoanal ultrasound identifies anal sphincter anatomy, and evacuation proctography visualizes pelvic floor motion during simulated defecation. These complementary techniques can evaluate obstructed defecation and fecal incontinence. Our aim was to develop a single, nonionizing, minimally invasive modality to image global pelvic floor anatomy and motion. Methods We studied six patients with fecal incontinence and seven patients with obstructed defecation. The anal Sphincters were imaged with an endoanal magnetic resonance imaging (MRI) coil and endoanal ultrasound (five patients). MR fluoroscopy acquired images every 1.4–2 s, using a modified real-time, T2-weighted, single-shot, fast-spin echo sequence, recording motion as patients squeezed pelvic floor muscles and expelled ultrasound gel; no contrast was added to other pelvic organs. Six patients also had scintigraphic defecography. Results Endoanal ultrasound and MRI were comparable for imaging defects of the internal and external Sphincters. Only MRI revealed puborectalis and/or external sphincter atrophy; four of these patients had fecal incontinence. MR fluoroscopy recorded pelvic floor contraction during squeeze and recorded relaxation during simulated defecation. Corresponding comparisons for angle change and perineal descent during defecation were not significant; only MRI, but not scintigraphy, identified excessive perineal descent in two patients. Conclusions Pelvic MRI is a promising single, comprehensive, nonradioactive modality to measure structural and functional pelvic floor disturbances in defecatory disorders. This method may provide insights into mechanisms of normal and disordered pelvic floor function in health and disease.
Rudolph W Schouten - One of the best experts on this subject based on the ideXlab platform.
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integrity of the anal Sphincters after pouch anal anastomosis evaluation with three dimensional endoanal ultrasonography
Diseases of The Colon & Rectum, 2005Co-Authors: M P Gosselink, Rachel L West, Ernst J Kuipers, Bettina E Hansen, Rudolph W SchoutenAbstract:PURPOSE: The aim of the present study was to assess the integrity of the anal Sphincters after handsewn pouch-anal anastomosis performed with the help of a Scott retractor. For this purpose the anal Sphincters were visualized with three-dimensional endoanal ultrasonography. METHODS: Patients undergoing a colonic pouch-anal anastomosis or an ileal pouch-anal anastomosis were included. Before and six months after the procedure, the length and volume of both Sphincters were assessed with three-dimensional endoanal ultrasonography, and anal manometry was performed. Continence scores were determined using the Fecal Incontinence Severity Index (FISI). RESULTS: Fifteen patients with a colonic pouch and 13 patients with an ileal pouch were examined. Six months after the procedure, three-dimensional endoanal ultrasonography showed significant alterations of the internal anal sphincter in eight patients with a colonic pouch-anal anastomosis (53 percent) and in eight patients with an ileal pouch-anal anastomosis (62 percent). These alterations were characterized by asymmetry or thinning. No defects were seen in the colonic pouch group, but, in two patients with an ileal pouch, a small defect in the internal anal sphincter was found. A decrease in internal anal sphincter volume was seen only in patients with a colonic pouch-anal anastomosis (P = 0.009). In both groups the length of the internal anal sphincter and the length, thickness, and volume of the external anal sphincter remained the same. After the procedure a reduction of maximum anal resting pressure was found in both groups (colonic pouch: P < 0.001, ileal pouch: P = 0.001). Maximum anal squeeze pressure was reduced in only patients with an ileal pouch-anal anastomosis (P = 0.006). The observed alterations of the internal anal sphincter and the manometric findings showed no correlation with the postoperative Fecal Incontinence Severity Index scores. CONCLUSION: Handsewn pouch-anal anastomosis, performed with the help of a Scott retractor, only rarely leads to internal anal sphincter defects, but three-dimensional endoanal ultrasonography shows alterations of the internal anal sphincter in 57 percent of the patients. No correlation was observed between these alterations and the functional outcome.
