Academic literature on the topic 'Feacal incontinence'

Background. Transcutaneous tibial nerve stimulation is a simple, non-invasive treatment, which can be used to treat faecal incontinence. Optimal treatment regimen is not known and various stimulation regimens are used in different centers. The aim of this prospective study was to evaluate the efficacy of twice weekly transcutaneous tibial nerve stimulation for faecal incontinence patients, who have failed to respond to maximal conservative treatment. Material and methods. Twenty patients with faecal incontinence resistant to maximal conservative therapy were treated with transcutaneous posterior tibial nerve stimulation twice a week for six weeks. The number of the bowel movements per two weeks and the Cleveland Clinic Florida Feacal Incontinence Score were assessed before and after the treatment. The quality of life was estimated using the Faecal Incontinence Quality of Life questionnaire and the Gastrointestinal Quality of Life Index. Results. Effect was seen in 55% of patients. Two-week faecal incontinence episodes decreased from median 4 (2–84) to 2 (0–56) (p = 0.002). The mean Cleveland Clinic Florida Faecal Incontinence score improved from 10.9 ± 4.34 to 7.8 ± 3.96 (p = 0.002). The quality of life improved significantly after the treatment. The therapy was well tolerated and no participant experienced any adverse event. Conclusions. Transcutaneous tibial nerve stimulation twice a week for 6 weeks may be efficacious in patients with faecal incontinence, who have failed to respond to maximal conservative treatments.

Žymantas Jagelavičius, Narimantas Evaldas Samalavičius, Tomas Poškus, Liudvikas Kervys, Romanas Kęstutis DrąsutisKoloproktologijos poskyris, Pilvo chirurgijos III skyrius,Vilniaus universiteto ligoninės "Santariškių klinikos"Centro filialas, Žygimantų g. 3, LT-01102 VilniusEl. paštas: narimantsam@takas.lt Tikslas Retrospektyviai išnagrinėti Milligan–Morgan hemoroidektomijų patirtį, įvertinti vėlyvuosius rezultatus. Ligoniai ir metodai Išnagrinėtos 270 ligonių, 1985–1999 m. VUL „Santariškių klinikos“ Centro filiale operuotų nuo hemorojaus, ligos istorijos. Iš jų 252 operuoti Milligan–Morgan metodu. Registruotas ligonių amžius, lytis, ligos trukmė iki operacijos, hospitalizavimo trukmė, hemorojaus laipsnis. Antro laipsnio hemorojumi sirgo 20 (7,9%), trečio – 185 (73,4%), ketvirto – 47 (18,7%) ligoniai. Bendrinė nejautra taikyta 144 (57,1%), spinalinė – 64 (25,4%), vietinė – 44 (17,5%) ligoniams. Siekiant įvertinti vėlyvuosius rezultatus, nuo 2001 m. spalio iki 2002 m. spalio visi ligoniai buvo apklausti paštu ar telefonu pagal iš anksto paruoštą klausimyną. Į klausimus atsakė 150 (59,5%) ligonių. Rezultatai Iš 252 ligonių pooperacinė eiga komplikavosi 16 (6,3%) ligonių: devyniems (3,6%) – šlapinimosi sutrikimu, septyniems (2,8%) – kraujavimu; trys ligoniai operuoti dar kartą. Išangės sritis sugijo per 2–16, vidutiniškai per 4,6 savaites. Iš 150 apklaustųjų pakartotinai nuo recidyvo operuoti trys (2,0%) ligoniai. Jie operacinį gydymą įvertino: labai gerai – 69 (46,0%), gerai 68 – (45,3%), patenkinamai – 12 (8,0%), blogai – vienas (0,7%) ligonis. Sutrikusia išangės raukų funkcija skundėsi 25 (16,7%) ligoniai, ją vertinome pagal Klivlendo išmatų nelaikymo klasifikaciją: 1 balas – vienas (0,7%) ligonis, 2 balai – trys (2%), 3 balai – šeši (4%), 4 balai – šeši (4%), 5 balai – nebuvo, 6 balai – trys (2,0%), 7 balai – nebuvo, 8 balai – du (1,3%), 9 balai – nebuvo, 10 balų – vienas (0,7%). Išvados Hemoroidektomija Milligan–Morgan būdu yra saugi ir veiksminga. Dauguma ligonių chirurginiu gydymu buvo patenkinti. Tačiau nereikia pamiršti, kad ir nedidelei daliai ligonių gali sutrikti išangės raukų funkcija. Reikšminiai žodžiai: hemorojus, Milligan–Morgan hemoroidektomija, rezultatai, išmatų nelaikymas Milligan–Morgan hemorrhoidectomies: experience of the Center Branch of Vilnius Univerity "Santariškių klinikos" Hospital Žymantas Jagelavičius, Narimantas Evaldas Samalavičius, Tomas Poškus, Liudvikas Kervys, Romanas Kęstutis Drąsutis Objective Retrospective analysis of the experience and long-term results after Milligan–Morgan hemorrhoidectomy. Patients and methods During the period 1985–1999, 270 patients underwent hemorrhoidectomy in our hospital, of them 252 by using the Milligan–Morgan technique. We registered the age and sex of patients, time of illness and of hospitalization, degree of hemorrhoids: 20 (7.9%) had II°, 185 (73.4%) – III°, 47 (18.7%) – IV°. General anesthesia was used in 144 (57.1%), regional (spinal or epidural) in 64 (25.4%), local in 44 (17.5%) patients. To evaluate long-term results, all patients were interviewed by telephone or mail under a special questionnaire; 150 (59,5%) patients replied. Results Of 252 patients, 16 (6.3%) developed postoperative complications: nine (3.6%) troubles of urination, six (2.4%) bleeding, one (0.4%) early recurrence; three patients were reoperated on. The anal region healed over 2–16 (average 4.6) weeks. Three patients (2.0%) of the 150 interviewed were operated on repeatedly because of recurrence. They evaluated our surgical treatment: very good 69 (46.0%), good 68 (45.3%), satisfactory 12 (8.0%), bad one (0.7%) patient. Faecal incontinence was mentioned by 25 (16.7%) patients. We ranked it using Cleveland’s feacal incontinence classification: 1 point – one (0.7%) patient, 2b. – three (2%), 3b. – six (4%), 4b. – six (4%), 5b. – zero, 6b. – three (2.0%), 7b. – zero, 8b. – two (1.3%), 9b. – zero, 10b. – one (0.7%) patient. Conclusions Milligan–Morgan hemorrhoidectomy in our experience is a rather safe and effective method of treatment of hemorrhoides. The majority of the patients were satisfied with our treatment. However, we should have in mind that for a small part of patients mild faecal incontinence is possible. Keywords: hemorrhoids, Milligan–Morgan hemorrhoidectomy, results, incontinece

Objective: The objectives of the study are to compare the outcome of the Doppler Guided Haemorrhoidal Artery Ligation andopen Haemorrhoidectomy in 2nd & 3rd Degree Haemorrhoids. Study design: Comparative study. Place and duration of study: Study wascarried out at the General Surgical Department at Liaquat University Hospital, Jamshoro & private hospital Hyderabad from 2008 – 2009.Methodology: Study consisted of 50 patients of diagnosed cases of heamorrhoid. Patients were divided in two groups. In Group A Standardopen Haemorrhoidectomy and Group B we used Doppler Guided Haemorrhoidal artery ligation. Detailed history was taken from all the patientswith special regard to the bleeding per rectum or some thing coming out during defecation and Clinical examination of anal canal DRE andProctoscopy was done. Results: In both groups male were 37 (74%) and female 13 (26%) with male: Female Ratio of 2:8:1. Age ranging from20 to 60 years in both group, mean ages of patients were 38.28 + 10.355 years. 3rd degree haemorrhoid 31(62%) while 2nd degree 19(38%).Complications were mild to moderate pain 24(96%) patients in DG – HAL group while moderate to severe pain 23(92%) in excisionalheamorrhoidectomy group. Anal stenosis in 2(8%), patients, anal fissure 1(4%) patients and feacal incontinence 1(4%) patients were observedonly in excisional heamorrhoidectomy. Recurrence occurred in one case (4%) in each group. Conclusions: DG – HAL procedure has a low rateof complications, earlier mobilization, implies a shorter hospital stay and offers the patient a more comfortable postoperative period thanExcisional heamorrhoidectomy procedure.

Objectives: To study the association and outcome of the primary repair obstetric perineal injures. Design: Cross sectional study. Methods: Patients presenting with third and fourth degree tears were included, factors associated with injures were studied. Primary repair was performed and outcome was looked after three months of repair. Results: Sixty Four (64) patients were studied in 18 months 59% were having their first pregnancy. Instrumental deliveries an macrosomia are strong associations. Primary repair with end to end approximation was done which was successful. Conclusion: Prevention is important Mediolateral episiotomy and skill of instrumental deliveries can minimize the risk of obstetrics perineal injures. Key Words: erineal tears, feacal incontinence, instrumental deliveries, mediolateral episiotomy.

Anal incontinence (AI) has a debilitating and devastating impact on a person’s quality of life. However the impact is often unreported due to the social stigma that surrounds AI and the utilisation of ineffective symptom severity scores which accurately assess the impact on quality of life. There is a significant amount of research literature which addresses the prevalence and cause of AI. Less information addresses the increased risk of AI following vaginal delivery and damage to the anal sphincter. Furthermore, women’s experiences of AI following obstetric anal sphincter injury (OASIS) and the impact on their quality of life are poorly reflected within research literature. The research study reported within this thesis adds to the existing body of knowledge surrounding AI, OASIS and impact on quality of life. Accordingly findings from the reported study will assist health professionals to derive a greater understanding of the issues that surround AI and further promote the development of sensitive appropriate healthcare. The reported interpretive phenomenological study explored and interpreted ten women’s experiences of AI following a history of OASIS, and illuminated the impact of AI on their quality of life. Heidegger’s interpretive phenomenology and Van Manen’s methodological framework guided the reported research study. Semi-structured open ended interviews were adopted as they encouraged a relaxed informal discussion between the researcher and participant eliciting rich in-depth accounts of women’s experiences. Data collection, analysis and interpretation were undertaken utilising Van Manen’s procedural framework. This framework aided the development of three essential themes; grieving for loss, silence and striving for normality. The research findings highlighted the debilitating physical, social and emotional impact of AI on women’s lives. Women described the need to adopt strategies to cope with the impact of AI. These strategies included lifestyle changes, silence, avoidance and denial. Furthermore it was evident from within the findings that new knowledge had arisen. Women grieved the loss of their identity, and ability to form successful relationships and loss of control as an adult, a mother and a partner. Loss was further compounded by the insidious and unpredictable nature of AI which negatively impacted on women’s psychological wellbeing. Findings from the reported research study will challenge the reader’s current assumptions of AI and its impact on women’s quality of life. In addition, health professionals need to be well informed as to the risks and impact of vaginal delivery, OASIS and AI. Recommendations for health professionals practice include adopting a proactive approach in breaking the silence that surrounds AI, illuminating potential health issues and promoting sensitive appropriate health care and informed choice in birthing outcomes. Paucity within research literature and current findings provide the impetus for further research within the area of AI and importantly, the psychological impact of AI on women’s quality of life.
Thesis (M.Nurs.Sc.) -- University of Adelaide, School of Nursing, 2012