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Analysis of differences in Pelvic Organ Prolapse Quantification scores at different anatomical sites before and after anesthesia for guiding surgical planning in female patients with pelvic organ prolapse 认领 引用
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作者 Su Lin Pan Hu +6 位作者 Hui Nie Li Lei Yingxia He Lin Feng Limei Zhao Chunhua Han Lubin Liu 《Asian Journal of Urology》 CAS CSCD 2026年第1期101-106,共6页
Objective:This study aimed to analyze the differences in Pelvic Organ Prolapse Quantitation(POP-Q)scores before and after anesthesia in patients with pelvic organ prolapse at different sites and explore the influence ... Objective:This study aimed to analyze the differences in Pelvic Organ Prolapse Quantitation(POP-Q)scores before and after anesthesia in patients with pelvic organ prolapse at different sites and explore the influence of POP-Q scores on surgical decision making.Methods:A prospective observational study was conducted involving 60 female patients with pelvic organ prolapse who underwent surgical treatment at the Chongqing Health Center for Women and Children between January 2023 and June 2023.The cohort included 26 patients with uterine prolapse and 34 patients with cystocele.POP-Q scores and other relevant data were compared under two conditions:before anesthesia(with Valsalva maneuver)and after anesthesia(with cervical traction).Results:There were no statistical differences in the mean age,menopausal status,mean body mass index,mean number of pregnancies,or related primary diseases between the two groups(p>0.05).The minimum tractive force required for cervical traction after anesthesia was 4.81 N.In both groups,the POP-Q scores for points C,D,and Bp were significantly higher after anesthesia than before anesthesia(p0.05).However,in the cystocele group,the score for point Aa decreased significantly after anesthesia compared to before anesthesia(p=0.016).Conclusion:The increased scores of points C,D,and Bp after anesthesia suggest that the evaluations of uterine prolapse should be based on post-anesthesia measurements.Conversely,evaluations of cystocele should rely on pre-anesthesia measurements due to the decrease in point Aa scores observed after anesthesia. 展开更多
关键词 Pelvic organ prolapse Pelvic Organ Prolapse Quantitation score Valsalva maneuver Mechanical traction after anesthesia
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Perception of rectal prolapse symptoms in patients with psychiatric disorders 认领 引用
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作者 Nouf Akeel Charlotte Mary Rajasingh +5 位作者 Michelle Earley Sydni Au Hoy Leila Neshatian Ekene Enemchukwu Kavita Mishra Brooke Gurland 《World Journal of Gastrointestinal Surgery》 SCIE 2026年第1期244-252,共9页
BACKGROUND The perception of symptoms in individuals with rectal prolapse(RP)can be influenced by psychiatric disorders(PD).It was hypothesized that women with a history of PD would experience higher levels of bother ... BACKGROUND The perception of symptoms in individuals with rectal prolapse(RP)can be influenced by psychiatric disorders(PD).It was hypothesized that women with a history of PD would experience higher levels of bother from RP symptoms.AIM To examine the relationship between PD and symptom severity in women with RP.METHODS A retrospective analysis was conducted on female patients with RP from an approved registry.Demographic data,medical history,and prolapse-associated symptoms were collected.Validated questionnaires were used to measure the severity of symptoms and degree of associated bother.Patients with and without psychiatric history were compared.RESULTSAmong the 200 patients included in the study,83(42%)had a PD,with depression(n=46)and anxiety(n=38)being the most prevalent.Patients with psychiatric history were younger(mean age:58±16)compared to thosewithout PD(mean age:66±15;P<0.001).The patients with PD reported higher scores on the Pelvic Floor DistressInventory Questionnaire-20[median(interquartile range):137.5(77.08,180.21)vs 101.04(67.71,150)]and PelvicFloor Impact Questionnaire-7[median(interquartile range):100(59.52,171.43)vs 80.95(38.10,142.86)].The bowelsymptoms were the primary contributors to the distress experienced by these patients.CONCLUSIONWomen with RP have a higher prevalence of PD and perceive bowel symptoms as more severe.Routine screeningfor PD is recommended and may improve patients’outcomes. 展开更多
关键词 Rectal prolapse Psychiatric disorders Pelvic Floor Distress Inventory Questionnaire-20 Pelvic Floor Impact Questionnaire-7 Bowel dysfunction
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Sutured rectal lift for obstructed defecation:Mesh-free sphincterpreserving transanal technique for Oxford gradeⅡ-Ⅲprolapse 认领 引用
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作者 Claudio Eduardo Pagano Sonia Sarnari +4 位作者 Umberto Favetta Roberto Picheo Fabrizio Gambarini Angelo Guttadauro Michele Schiano di Visconte 《World Journal of Gastrointestinal Surgery》 SCIE 2026年第3期305-314,共10页
BACKGROUND Obstructed defecation syndrome(ODS)frequently results from an internal rectal prolapse,which disrupts the rectal axis and impairs evacuation.Resectional transanal operations can remove redundant tissue,but ... BACKGROUND Obstructed defecation syndrome(ODS)frequently results from an internal rectal prolapse,which disrupts the rectal axis and impairs evacuation.Resectional transanal operations can remove redundant tissue,but fail to restore structural support,whereas abdominal mesh rectopexy involves prosthetic materials and has a higher operative burden.The sutured rectal lift(SuReL)was developed as a reconstructive,non-resective,and mesh-free transanal technique to restore rectal suspension while preserving continence in patients with ODS secondary to internal prolapse.AIM To describe the rationale,indications,and step-by-step operative technique of SuReL for Oxford gradeⅡ-Ⅲinternal rectal prolapse causing obstructed defecation.METHODS SuReL was performed using the Sylarum®transanal access device.The rectal wall was addressed sequentially in six circumferential sectors(11,1,9,3,7,and 5 o’clock).In each sector,a triphasic suture sequence with a barbed 0/0 monofilament(Filbloc®)was placed:(1)A mucosa-submucosa pass;(2)A deeper pass including the muscularis layer at the same level;and(3)A third pass 3 mm caudally,forming a semiloop for suspension.Cranial plications advanced distally to the upper limit of the prolapse.A deep circumferential reinforcement layer with a 2/0 Assuplus®monofilament consolidated the lift.RESULTS The procedure standardizes the reconstructive phase through sector-based rotation,allowing symmetric traction and full-thickness suspension without resection.Operative pearls consist of maintaining uniform exposure,ensuring precise semiloop depth for tension control,and verifying lumen patency with saline irrigation.Key technical advantages include the absence of stapling devices or prosthetic materials,minimal bleeding,a short operative time,and preservation of mucosal sensitivity.Postoperative recovery is typically rapid with early mobilization and minimal discomfort.CONCLUSION SuReL represents a technically reproducible and standardized approach for the treatment of internal rectal prolapse.This preclinical study demonstrated feasibility and mechanical consistency using anatomical simulators,while the clinical efficacy and physiological benefits remain to be validated in prospective trials. 展开更多
关键词 Obstructed defecation syndrome Internal rectal prolapse Transanal surgery Sphincter preservation Rectal suspension Surgical standardization
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The Anti-Senescence Effect andMechanism of 17β-Estradiol on Pelvic Organ Prolapse Derived Fibroblasts 认领 引用
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作者 Juan Cheng Zhiwei Zhao +3 位作者 Ling Wang Jirui Wen Yali Miao Jiang Wu 《BIOCELL》 SCIE 2025年第2期335-348,共14页
Objectives:Recently,pre-/post-operative Local Estrogen Therapy(LET)has shown effectiveness in alleviating Pelvic Organ Prolapse(POP)symptoms in clinical therapy.However,there is a lack of scientific evidence to suppor... Objectives:Recently,pre-/post-operative Local Estrogen Therapy(LET)has shown effectiveness in alleviating Pelvic Organ Prolapse(POP)symptoms in clinical therapy.However,there is a lack of scientific evidence to support these claims.Therefore,we aimed to explore the anti-senescence effects and mechanisms of 17β-estradiol(E2)on POP-derived fibroblasts.Methods:The primary fibroblast cells were isolated and cultured fromthe surgical samples of postmenopausal women clinically diagnosed with pelvic organ prolapse(POP)at stages III-IV(quantified using the POP-Q system)and without any other treatment within 6 months.(n=12,age 50–75).Colorimetric Cell Counting Kit(CCK-8)assay and Senescence-Associated-β-Galactosidase(SA-β-Gal)staining were used to test the cell proliferative capacity and the senescence rate.Western blotting(WB)was used to detect the expression of Collagen Type I(COL-I),Collagen Type III(COL-III),Cyclin-dependent kinase 4 inhibitor A(p16INK4a),Cyclin-dependent kinase inhibitor 1A(p21),Tumor Protein 53(p53),Sirtuin 1(SIRT-1)and Microtubule-associated protein 1A/1B-light chain 3-I/II(LC3-I/II)protein.A transmission ElectronMicroscope(TEM)was used to observe the ultrastructure of fibroblasts.Results:The results showed that E2 significantly promoted the proliferation of fibroblasts derived from POP and reduced the staining rate of SA-β-Gal.It markedly enhanced the extracellular matrix proteins COL-I and COL-III,accompanied by inhibition of the senescent maker p16INK4a.Additionally,our results improved the cells’autophagy and metabolic activity.Additionally,our results indicate the anti-senescence mechanism of E2 through the mediated SIRT-1/p53/p21 axis pathway.Conclusion:We provide preliminary evidence for the anti-aging effects and mechanisms of E2 on POP,hoping to provide a theoretical basis for estrogen against POP senescence and guide the clinical application and local administration of estrogen in POP treatment. 展开更多
关键词 Pelvic organ prolapse(POP) vaginal anterior wall prolapse 17β-estradiol(E2) senescence fibroblasts
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Surgical approaches for complete rectal prolapse 认领 引用 被引量：1
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作者 Long Wu Huan Wu +3 位作者 Song Mu Xiao-Yun Li Yun-Huan Zhen Hai-Yang Li 《World Journal of Gastrointestinal Surgery》 SCIE 2025年第3期47-56,共10页
Complete rectal prolapse,characterized by the protrusion of the rectal wall layers through the anal canal,poses significant treatment challenges,particularly due to controversies surrounding surgical approaches and th... Complete rectal prolapse,characterized by the protrusion of the rectal wall layers through the anal canal,poses significant treatment challenges,particularly due to controversies surrounding surgical approaches and the absence of a standardized assessment system.This study comprehensively reviews the main surgical tech-niques for complete rectal prolapse,categorized as transabdominal and transpe-rinealransanal procedures.Despite various techniques,challenges persist,inclu-ding high recurrence rates and potential complications.Factors influencing the choice of the surgical approach include patient characteristics,symptomatology,and surgical expertise.With advances in medical technology,laparoscopic and robotic surgeries offer promising avenues,albeit with considerations of cost and accessibility.Ultimately,treatment plans tailored to the individual needs of the patient and surgical expertise are essential.Although controversies remain,the continued refinement of surgical techniques holds promise for improving out-comes in complete rectal prolapse surgery. 展开更多
关键词 Rectal prolapse Surgery Procedure Treatment Review
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Physiological Reconstruction for Moderate–Severe Pelvic Organ Prolapse:A Multicenter Retrospective Self-Controlled Study 认领 引用
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作者 Zhen-hua Gao Xing-qi Wang +3 位作者 Kun-bin Ke Quan Zhang Ling Li Ji-hong Shen 《Current Medical Science》 SCIE CAS CSCD 2025年第4期909-916,共8页
Objective This is a self-controlled multicenter retrospective study based on the clinical efficacy and complications of physiological reconstruction in the treatment of moderate and severe pelvic organ prolapse.Method... Objective This is a self-controlled multicenter retrospective study based on the clinical efficacy and complications of physiological reconstruction in the treatment of moderate and severe pelvic organ prolapse.Methods From December 2014 to August 2021,517 women were included and registered for physiological reconstruction at four Chinese urogynecology institutions.We enrolled 364 women with POP-Q stage≥3.The degree of POP was quantified via a POP-Q system.The surgical purpose of physiological reconstruction is to repair the vagina,levator ani muscle,perineum,and urogenital hiatus and adopt a repair method in accordance with the axial direction of physiology.All 330 evaluable participants were followed for 2 years.The evaluation indices included the PFDI-20,PGI-I,PFIQ-7,PISQ-12,PGI-I,and PGI-S.All complications were coded according to the category-time-site system proposed by the International Urogynecological Association(IUGA)and International Continence Society(ICS).Results Compared with the preoperative POP-Q scores,statistically significant improvements were observed at the 6-month,1-year and 2-year time points(P<0.001).Statistically significant improvements in quality of life were observed across all time points.Conclusions Physiologic reconstructive surgical techniques combined with modified anterior pelvic floor mesh implantation could help restore the physiologic axis and vaginal shape,which may be the most important factors in maintaining the functional position of pelvic floor organs and is the most effective method for repairing the pelvic fascia tendon arch.This surgical method is safe,feasible,and effective in patients with severe prolapse. 展开更多
关键词 Physiological reconstruction Pelvic organ prolapse Pelvic floor reconstruction Mesh implantation Surgical outcomes Treatment efficacy Complications Retrospective analysis
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Optimizing circumferential prolapsed hemorrhoid surgery:Transverse incision with longitudinal ligation procedure delivers superior radicality compared to Milligan-Morgan technique 认领 引用 被引量：1
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作者 Xin-Bo Song Yan-Zhi Wang +7 位作者 Yan-Mei Wang Hong Sun Jia-Nan Li Huang-Fu Ma Xin Li Ting-Ting Sui Rui-Han Liu Li-Xia Lai 《World Journal of Gastroenterology》 SCIE CAS 2025年第39期153-160,共8页
BACKGROUND Circumferential prolapsed hemorrhoids(CPHs)necessitate surgical intervention.While Milligan-Morgan hemorrhoidectomy(MMH)remains widely used,it compromises functional preservation and associates with signifi... BACKGROUND Circumferential prolapsed hemorrhoids(CPHs)necessitate surgical intervention.While Milligan-Morgan hemorrhoidectomy(MMH)remains widely used,it compromises functional preservation and associates with significant post-operative pain,edema,and delayed healing in severe CPH cases.To address these limitations,our research team innovatively proposed the transverse incision with longitudinal ligation procedure(TILL).This novel technique utilizes targeted transverse incisions and longitudinal pedicle ligation to optimize complete resection while preserving anal anatomy and function.METHODS A total of 180 patients were retrospectively reviewed in China.The patients were divided into two groups of 90 based on the surgical methods.The treatment group underwent the TILL procedure,while the control group underwent MMH.The main observation index was the evaluation of clinical efficacy after wound healing.Secondary outcomes included the recurrence rate and wound healing time.Safety measurements were also evaluated.RESULTS The TILL group showed a significant difference compared to the MMH group(P=0.022),indicating better overall treatment effects.The time for wound healing in the TILL group was shorter than that in the MMH group(P=0.001).Compared to those who underwent MMH,those who underwent TILL experienced significantly reduced postoperative pain,with lower average scores for anal edema and anal stenosis(both P<0.05).CONCLUSION TILL demonstrates superior efficacy to MMH for advanced CPH,reducing recovery times and postoperative pain,edema,and stenosis while preserving anal function. 展开更多
关键词 Circumferential prolapsed hemorrhoid Milligan-Morgan hemorrhoidectomy Transverse incision with longitudinal ligation procedure Efficacy Anal function
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Clinicopathologic features of 89 patients with lacrimal gland prolapse 认领 引用
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作者 Yu-Yao Qu Le Dong +7 位作者 Ya-Guang Hu Ning Gao Jing-Ming Li Qiao-Chu Cheng Shan Gao Ting Wei Jian-Min Ma Wan-Hu Zhang 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2025年第6期1011-1015,共5页
AIM:To analyze the clinical and pathological features of 89 patients presenting as lacrimal gland prolapse(LGP).METHODS:This retrospective study included 89 patients presenting as LGP.Magnetic resonance imaging(MRI)sc... AIM:To analyze the clinical and pathological features of 89 patients presenting as lacrimal gland prolapse(LGP).METHODS:This retrospective study included 89 patients presenting as LGP.Magnetic resonance imaging(MRI)scan was performed for all patients.Pathology and immunohistochemical staining of prolapsed tissue were performed during the surgery.The histopathological subtype was obtained,and the related clinical manifestations of different subtype were marked.RESULTS:Among the 89 patients involved,the histopathological subtype includes dacryoadenitis(43%;n=38),focal lymphocytes infiltration(20%;n=18),immunoglobulin G4(IgG4)-related lacrimal gland inflammatory disease(15%;n=13),lacrimal gland(13%;n=12),and extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue(9%;n=8).As for manifestations of different subtypes,eyelid swelling was found the most frequent of lymphocytes infiltration(44%,n=8),and palpable lacrimal gland mass of dacryoadenitis(55%,n=21).All the IgG4-related lacrimal gland inflammatory disease(100%,n=13)and most dacryoadenitis(97%,n=37)presented as bilateral.CONCLUSION:LGP has the histopathological subtype most commonly as inflammation,followed by structural and lymphoproliferative changes.Most of patients present as eyelid swelling.Clinical manifestations can be significant to differentiate the diagnosis. 展开更多
关键词 lacrimal gland prolapse clinicopathologic features dacryoadenitis IgG4-related lacrimal gland inflammatory disease extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue
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Clinical Aspects and Functional Disorders in Patients with Genital Prolapse in Butembo 认领 引用
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作者 Amos Kaghoma Sivulyamwenge Jean-Jeannot Juakali Sihalikyolo +7 位作者 Jeremie Likilo Osundja Baraka Munyanderu Junior Burubu Lisi-Ankiene Patrick Magala Batakuya Jean Demupondo Lukangi Noel Labama Otuli Gedeon Katenga Bosunga Emmanuel Komanda Likwekwe 《Journal of Biosciences and Medicines》 2025年第2期190-201,共12页
Introduction: Genital prolapse is a health problem that gynaecologists are increasingly facing due to patients’ legitimate demands for care and the improvement in life expectancy without associated disabilities. The ... Introduction: Genital prolapse is a health problem that gynaecologists are increasingly facing due to patients’ legitimate demands for care and the improvement in life expectancy without associated disabilities. The objective of this work was to evaluate the clinical aspects and functional disorders of patients with genital prolapse in Butembo in Democratic Republic of the Congo (DRC). Material and Methods: A descriptive study with analytical aims was conducted from January 1 to September 30, 2024 in Butembo/DRC. It involved 112 patients with symptomatic genital prolapse in whom an interview on functional disorders as well as clinical assessment according to the Baden and Walker classification were carried out. The data were entered into Microsoft Office LTSC 2021 Excel software and analysed using R software version 4.4.0. Results: Patients aged over 50 years were exposed to developing genital prolapse especially the mixed type (81.1%) compared to those aged under 50 years (p-value 0.014). Multi and large multiparous women had developed all types of prolapse especially the mixed type (100%) compared to primiparous and pauciparous women (p-value 0.027). Associated pathologies were more observed in case of mixed prolapse (51.4%) including vesicovaginal fistula (37.8%) (p-value Conclusion: Genital prolapse is common and functional urinary, sexual and anorectal signs are frequently observed in patients in Butembo/DRC. 展开更多
关键词 Genital Prolapse Functional Disorders Urinary Incontinence Anorectal Disorders Butembo
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Mucosal Prolapse of the Urethra in Little Girls about 11 Cases at the Urology Department of the Sino-Guinean Friendship Hospital in Conakry (Guinea) 认领 引用
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作者 Thierno Amadou Oury Sow Mohamed Habiboullah Ova +3 位作者 Thierno Mamadou Oury Diallo Ibrahima Bah Abdoulaye Bobo Diallo Oumar Raphiou Bah 《Open Journal of Urology》 2025年第1期1-6,共6页
Introduction: Urethral prolapse, a rare benign lesion of the female urethra, is considered unusual in children, but it is far from exceptional in girls aged 18 to 24. African origin. The diagnosis is clinical but can ... Introduction: Urethral prolapse, a rare benign lesion of the female urethra, is considered unusual in children, but it is far from exceptional in girls aged 18 to 24. African origin. The diagnosis is clinical but can be overlooked or confused with other pathologies. Treatment remains controversial. The aim of this work is to study the epidemiological, clinical and therapeutic data of urethral mucosal prolapse in young girls in our department. Materials and methods: Retrospective and descriptive study on urethral mucosal prolapse in little girls identified from the hospitalization records of the Sino-Guinean Friendship Hospital in Conakry. The study period was 5 years. Patients were selected randomly. Outcome assessment focused on the occurrence of recurrences and urinary incontinence. The mean follow-up duration was 24 months. The parameters studied were: Age, clinical and histological findings, therapeutic data and patient outcomes. Results: The incidence of urethral mucosal prolapse in girls in the urology department was 2.2 cases/year. The mean age of the patients was 6.7 years (with extremes of 5 months and 10 years). The age group of 7 to 10 years was the most represented, observed in 63.63% of patients. The most frequent reason for consultation was vulvar bleeding in 7 patients, or 63.63%. Malpighian hyperplasia with a congested chorion was the most observed histological type, in 4 patients. Surgical treatment consisting of complete excision of the prolapsed part had given excellent results. Conclusion: Urethral prolapse is a rare pathology, observed mainly in young black girls. Its diagnosis is based mainly on clinical examination. Surgical treatment gives satisfactory results, both clinically and aesthetically. 展开更多
关键词 Urethral Prolapse Little Girl Squamous Hyperplasia Guinea Conakry
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Transvaginal sacrospinous ligament fixation:Efficacy in treating pelvic prolapse and influence on patients’anxiety and depression 认领 引用 被引量：1
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作者 Rui-Rui Zhang Rui-Heng Zhao +2 位作者 Lei Zhang Ru-Yue Ma Mei-Zhu Chen 《World Journal of Psychiatry》 SCIE 2025年第12期167-176,共10页
BACKGROUND Pelvic organ prolapse(POP)can lead to urinary incontinence,fecal incontinence,and other symptoms,affecting the quality of life,which results in anxiety and depression and other negative emotions in many pat... BACKGROUND Pelvic organ prolapse(POP)can lead to urinary incontinence,fecal incontinence,and other symptoms,affecting the quality of life,which results in anxiety and depression and other negative emotions in many patients.Trans-vaginal sacrospinous ligament suspension(VSSLS)involves securing the apex of the prolapsed vagina to the sacrospinous ligament to maintain the physiological axis of the vagina,help in repairing pelvic floor defects,and maintain the normal function of the pelvic floor,thereby alleviating patients’anxiety and depression.AIM To explore the effect of VSSLS in the treatment of POP and its influence on anxiety and depression among patients.METHODS Sixty patients with moderate to severe POP who underwent surgical treatment between January 2023 and June 2024 in Suzhou Ninth Hospital Affiliated to Soochow University were retrospectively enrolled in the study.According to treatment methods,they were divided into the control group(n=30,treated with vaginal hysterectomy alone)and observation group(n=30,treated with VSSLS combined with vaginal hysterectomy).The two groups were compared by baseline data,perioperative indicators,and postoperative pain intensity,prolapse distance before and after surgery,sexual function,pelvic function,anxiety,and depression.RESULTS No significant differences in baseline data,preoperative POP Quantification measurement value,Pelvic Floor Dysfunction Inventory 20(PFDI-20),Pelvic Floor Impact Questionnaire 7(PFIQ-7),Self-Rating Anxiety Scale(SAS),and Self-Rating Depression Scale(SDS)scores were found between the two groups.The obser vation group had longer operation time and more intraoperative blood loss than the control group,the Visual Analog Scale score on postoperative day 1 was slightly higher in than in the control group.On the reexamination 3 months postoperatively,the POP Quantification measurement values in the observation group were lower than those in the control group(P<0.05).Evaluation 6 months after surgery,the FSFI score was higher in the observation group than in the control group,the PFDI-20,PFIQ-7,SAS and SDS score scored were lower in than in the control group(P<0.05).The PFDI-20,PFIQ-7 scores positively correlated with the SAS and SDS scores.CONCLUSION VSSLS demonstrated a significant effect on the treatment of moderate and severe POP,as it can reduce the prolapse distance and PFDI-20 and PFIQ-7 scores and improve anxiety and depression among patients. 展开更多
关键词 Pelvic organ prolapse Trans-vaginal sacrospinous ligament suspension Pelvic function Anxiety Depression
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Current status of laparoscopic and robotic ventral mesh rectopexy for external and internal rectal prolapse 认领 引用 被引量：27
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作者 Jan J van Iersel Tim JC Paulides +3 位作者 Paul M Verheijen John W Lumley Ivo AMJ Broeders Esther CJ Consten 《World Journal of Gastroenterology》 SCIE CAS 2016年第21期4977-4987,共11页
External and internal rectal prolapse with their affiliated rectocele and enterocele, are associated with debilitating symptoms such as obstructed defecation, pelvic pain and faecal incontinence. Since perineal proced... External and internal rectal prolapse with their affiliated rectocele and enterocele, are associated with debilitating symptoms such as obstructed defecation, pelvic pain and faecal incontinence. Since perineal procedures are associated with a higher recurrence rate, an abdominal approach is commonly preferred. Despite the description of greater than three hundred different procedures, thus far no clear superiority of one surgical technique has been demonstrated. Ventral mesh rectopexy(VMR) is a relatively new and promising technique to correct rectal prolapse. In contrast to the abdominal procedures of past decades, VMR avoids posterolateral rectal mobilisation and thereby minimizes the risk of postoperative constipation. Because of a perceived acceptable recurrence rate, good functional results and low mesh-related morbidity in the short to medium term, VMR has been popularized in the past decade. Laparoscopic or robotic-assisted VMR is now being progressively performed internationally and several articles and guidelines propose the procedure as the treatment of choice for rectal prolapse. In this article, an outline of the current status of laparoscopic and robotic ventral mesh rectopexy for the treatment of internal and external rectal prolapse is presented. 展开更多
关键词 Laparoscopic ventral mesh rectopexy Robot Rectal prolapse External rectal prolapse Internal rectal prolapse Rectocele Mesh erosion Obstructed defecation Faecal incontinence Biological mesh
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Clinical efficacy of integral theory–guided laparoscopic integral pelvic floor/ligament repair in the treatment of internal rectal prolapse in females 认领 引用 被引量：4
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作者 Yang Yang Yong-Li Cao +6 位作者 Yuan-Yao Zhang Shou-Sen Shi Wei-Wei Yang Nan Zhao Bing-Bing Lyu Wen-Li Zhang Dong Wei 《World Journal of Clinical Cases》 SCIE 2020年第23期5876-5886,共11页
BACKGROUND Internal rectal prolapse(IRP)is one of the most common causes of obstructive constipation.The incidence of IRP in women is approximately three times that in men.IRP is mainly treated by surgery,which can be... BACKGROUND Internal rectal prolapse(IRP)is one of the most common causes of obstructive constipation.The incidence of IRP in women is approximately three times that in men.IRP is mainly treated by surgery,which can be divided into two categories:Abdominal procedures and perineal procedures.This study offers a better procedure for the treatment of IRP.AIM To compare the clinical efficacy of laparoscopic integral pelvic floor/ligament repair(IPFLR)combined with a procedure for prolapse and hemorrhoids(PPH)and the laparoscopic IPFLR alone in the treatment of IRP in women.METHODS This study collected the clinical data of 130 female patients with IRP who underwent surgery from January 2012 to October 2014.The patients were divided into groups A and B.Group A had 63 patients who underwent laparoscopic IPFLR alone,and group B had 67 patients who underwent the laparoscopic IPFLR combined with PPH.The degree of internal rectal prolapse(DIRP),Wexner constipation scale(WCS)score,Wexner incontinence scale(WIS)score,and Gastrointestinal Quality of Life Index(GIQLI)score were compared between groups and within groups before surgery and 6 mo and 2 years after surgery.RESULTS All laparoscopic surgeries were successful.The general information,number of bowel movements before surgery,DIRP,GIQLI score,WIS score,and WCS score before surgery were not significantly different between the two groups(all P>0.05).The WCS score,WIS score,GIQLI score,and DIRP in each group 6 mo,and 2 years after surgery were significantly better than before surgery(P<0.001).In group A,the DIRP and WCS score gradually improved from 6 mo to 2 years after surgery(P<0.001),and the GIQLI score progressively improved from 6 mo to 2 years after surgery(P<0.05).In group B,the DIRP,WCS score and WIS score significantly improved from 6 mo to 2 years after surgery(P<0.05),and the GIQLI score 2 years after surgery was significantly higher than that 6 mo after surgery(P<0.05).The WCS score,WIS score,GIQLI score,and DIRP of group B were significantly better than those of group A 6 mo and 2 years after surgery(all P<0.001,Bonferroni)except DIRP at 2 years after surgery.There was a significant difference in the recurrence rate of IRP between the two groups 6 mo after surgery(P=0.011).There was no significant difference in postoperative grade I-III complications between the two groups(P=0.822).CONCLUSION Integral theory–guided laparoscopic IPFLR combined with PPH has a higher cure rate and a better clinical efficacy than laparoscopic IPFLR alone. 展开更多
关键词 Internal rectal prolapse Integral theory Integral pelvic floor/Ligament repair Procedure for prolapse and hemorrhoids Clinical efficacy Minimally invasive surgery for treatment of constipation
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Evaluation of the clinical efficacy and safety of TST33 mega hemorrhoidectomy for severe prolapsed hemorrhoids 认领 引用 被引量：5
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作者 Liu Tao Jun Wei +1 位作者 Xu-Feng Ding Li-Jiang Ji 《World Journal of Clinical Cases》 SCIE 2022年第18期6060-6068,共9页
BACKGROUND The pathogenesis of hemorrhoids is mainly anal cushion prolapse.Although the traditional treatment has a certain curative effect,it is not ideal.The remission rate of postoperative symptoms is low.Even if t... BACKGROUND The pathogenesis of hemorrhoids is mainly anal cushion prolapse.Although the traditional treatment has a certain curative effect,it is not ideal.The remission rate of postoperative symptoms is low.Even if temporary remission is achieved,patients with hemorrhoids easily relapse after 1-2 years.The new technique of using staplers to treat prolapsed hemorrhoids has good therapeutic effects in clinical practice.AIM To explore the effect of TST33 mega stapler prolapse and hemorrhoid mucosal resection in the treatment of patients with severe prolapsed hemorrhoids.METHODS A total of 204 patients with severe prolapse hemorrhoids who were admitted to the department of anorectal in our hospital from April 2018 to June 2020 were selected,and the patients were randomly divided into group A and group B with 102 cases in each group using a randomized controlled clinical research program.Patients in Group A were treated with a TST33 mega stapler and hemorrhoid mucosal resection to treat prolapse,and patients in Group B were treated according to the Procedure for Prolapse and Hemorrhoids;the operation time,intraoperative blood loss,hospital stay,the difference in operation time,intraoperative blood loss,hospitalization time,pain degree before and after operation,degree of anal edema,anal Wexner score,and surgical complications were compared between the two groups of patients.RESULTS The operation time,intraoperative blood loss and hospitalization time in Group A were significantly lower than those in Group B(P0.05).The visual analogue scale(VAS)at 12 h and 24 h postoperatively in Group A were significantly lower than those in Group B(P0.05).One day postoperatively,the degree of perianal edema in Group A was compared with that in Group B,and the difference was not statistically significant(P>0.05).Seven days postoperatively,the degree of perianal edema in Group A was significantly lower than that in Group B(P0.05).The Wexner scores of the two groups at 1 mo,3 mo and 6 mo postoperatively were significantly lower than the scores preoperatively(P<0.05).The postoperative complication rate of Group A was 2.94%lower than that of Group B(11.76%),which was statistically significant(P<0.05).CONCLUSION TST33 mega anastomotic hemorrhoidectomy treatment for patients with severe prolapse hemorrhoids,leads to less postoperative pain,the rapid recovery of perianal edema and has fewer complications. 展开更多
关键词 TST33 mega stapler Prolapse of hemorrhoids Severe prolapsed hemorrhoids Hemorrhoids Circumcision
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Procedure for prolapse and hemorrhoids vs traditional surgery for outlet obstructive constipation 认领 引用 被引量：62
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作者 Ming Lu Bo Yang +2 位作者 Yang Liu Qing Liu Hao Wen 《World Journal of Gastroenterology》 SCIE CAS 2015年第26期8178-8183,共6页
AIM: To compare the clinical efficacies of two surgical procedures for hemorrhoid rectal prolapse with outlet obstruction-induced constipation.METHODS: One hundred eight inpatients who underwent surgery for outlet obs... AIM: To compare the clinical efficacies of two surgical procedures for hemorrhoid rectal prolapse with outlet obstruction-induced constipation.METHODS: One hundred eight inpatients who underwent surgery for outlet obstructive constipation caused by internal rectal prolapse and circumferential hemorrhoids at the First Affiliated Hospital of Xinjiang Medical University from June 2012 to June 2013 were prospectively included in the study.The patients with rectal prolapse hemorrhoids with outlet obstructioninduced constipation were randomly divided into two groups to undergo either a procedure for prolapse and hemorrhoids(PPH)(n = 54) or conventional surgery(n = 54; control group).Short-term(operative time,postoperative hospital stay,postoperative urinary retention,postoperative perianal edema,and postoperative pain) and long-term(postoperative anal stenosis,postoperative sensory anal incontinence,postoperative recurrence,and postoperative difficulty in defecation) clinical effects were compared between the two groups.The short- and long-term efficacies of the two procedures were determined.RESULTS: In terms of short-term clinical effects,operative time and postoperative hospital stay were significantly shorter in the PPH group than in the control group(24.36 ± 5.16 min vs 44.27 ± 6.57 min,2.1 ± 1.4 d vs 3.6 ± 2.3 d,both P < 0.01).The incidence of postoperative urinary retention was higher in the PPH group than in the control group,but the difference was not statistically significant(48.15% vs 37.04%).Theincidence of perianal edema was significantly lower in the PPH group(11.11% vs 42.60%,P < 0.05).The visual analogue scale scores at 24 h after surgery,first defecation,and one week after surgery were significantly lower in the PPH group(2.9 ± 0.9 vs 8.3 ± 1.1,2.0 ± 0.5 vs 6.5 ± 0.8,and 1.7 ± 0.5 vs 5.0 ± 0.7,respectively,all P < 0.01).With regard to long-term clinical effects,the incidence of anal stenosis was lower in the PPH group than in the control group,but the difference was not significant(1.85% vs 5.56%).The incidence of sensory anal incontinence was significantly lower in the PPH group(3.70% vs 12.96%,P < 0.05).The incidences of recurrent internal rectal prolapse and difficulty in defecation were lower in the PPH group than in the control group,but the differences were not significant(11.11% vs 16.67% and 12.96% vs 24.07%,respectively).CONCLUSION: PPH is superior to the traditional surgery in the management of outlet obstructive constipation caused by internal rectal prolapse with circumferential hemorrhoids. 展开更多
关键词 Internal rectal prolapse Outlet obstructiveconstipation Procedure for prolapse and hemorrhoids Prospective study Randomized controlled study
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Modified Gant procedure for treatment of internal rectal prolapse in elderly women 认领 引用 被引量：1
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作者 Peng-Peng Xu Yong-Hong Su +1 位作者 Yan Zhang Tong Lu 《World Journal of Clinical Cases》 SCIE 2021年第29期8702-8709,共8页
BACKGROUND Although rectal prolapse is not a life-threatening condition,it can cause defecation disorders,anal incontinence,sensory abnormalities,and other problems that can seriously affect quality of life.AIM To stu... BACKGROUND Although rectal prolapse is not a life-threatening condition,it can cause defecation disorders,anal incontinence,sensory abnormalities,and other problems that can seriously affect quality of life.AIM To study the efficacy of the modified Gant procedure for elderly women with internal rectal prolapse.METHODS Sixty-three elderly female patients with internal rectal prolapse underwent the modified Gant procedure.The preoperative and postoperative anal symptoms,Patient Assessment of Constipation Quality of Life(PAC-QOL),Wexner incontinence score,incontinence quality of life score,and complications(massive hemorrhage,infection,anorectal stenosis,and anorectal fistula)were compared.RESULTS The improvement rates of postoperative symptoms were defecation disorders(84.5%),anal distention(69.6%),defecation sensation(81.4%),frequent defecation(88.7%),and anal incontinence(42.9%)(P<0.05).All dimensions and total scores of the PAC-QOL after the procedure were lower than those before the operation(P<0.05).The postoperative anal incontinence score and Wexner score were significantly lower than those before the procedure(P<0.05).The quality of life and total scores of postoperative anal incontinence were significantly higher than those before the procedure(P<0.05).There were no serious complications and no deaths.CONCLUSION The modified Gant procedure has significant advantages in the treatment of elderly women with internal rectal prolapse. 展开更多
关键词 Modified Gant procedure Intrarectal prolapse Rectal Prolapse Elderly women
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Anterior rectopexy for full-thickness rectal prolapse: Technical and functional results 认领 引用 被引量：9
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作者 Jean-Luc Faucheron Bertrand Trilling +3 位作者 Edouard Girard Pierre-Yves Sage Sandrine Barbois Fabian Reche 《World Journal of Gastroenterology》 SCIE CAS 2015年第16期5049-5055,共7页
AIM:To assess effectiveness, complications, recurrence rate, and recent improvements of the anterior rectopexy procedure for treatment of total rectal prolapse.METHODS:MEDLINE, Pub Med, EMBASE, and other relevant data... AIM:To assess effectiveness, complications, recurrence rate, and recent improvements of the anterior rectopexy procedure for treatment of total rectal prolapse.METHODS:MEDLINE, Pub Med, EMBASE, and other relevant database were searched to identify studies.Randomized controlled trials, non-randomized studies and original articles in English language, with more than 10 patients who underwent laparoscopic ventral rectopexy for full-thickness rectal prolapse, with a follow-up over 3 mo were considered for the review.RESULTS:Twelve non-randomized case series studies with 574 patients were included in the review.No surgical mortality was described.Conversion was needed in 17 cases(2.9%), most often due to difficult adhesiolysis.Twenty eight patients(4.8%) presented with major complications.Seven(1.2%) mesh-related complications were reported.Most frequent complications were urinary tract infection and urinary retention.Mean recurrence rate was 4.7% with a median follow-up of 23 mo.Improvement of constipation ranged from 3%-72% of the patients and worsening or new onset occurred in 0%-20%.Incontinence improved in 31%-84% patients who presented fecal incontinence at various stages.Evaluation of functional score was disparate between studies.CONCLUSION:Based on the low long-term recurrence rate and favorable outcome data in terms of low de novo constipation rate, improvement of anal incontinence, and low complications rate, laparoscopic anterior rectopexy seems to emerge as an efficient procedure for the treatment of patients with total rectal prolapse. 展开更多
关键词 Total rectal prolapse Laparoscopy Anteriorrectopexy Ventral rectopexy Results Recurrence Systematic review
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Transcatheter closure of ventricular septal defect in patients with aortic valve prolapse and mild aortic regurgitation:feasibility and preliminary outcome 认领 引用 被引量：18
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作者 Guan-Liang Chen Hai-Tao Li +1 位作者 Hai-Rong Li Zhi-Wei Zhang 《Asian Pacific Journal of Tropical Medicine》 SCIE CAS 2015年第4期315-318,共4页
Objective:To evaluate the feasibility,safety and efficacy of transcathcter closure of ventricular septal defect(VSD)in patients with aortic valve prolapse(AVP)and mild aortic regurgitation(AR).Methods:Between January ... Objective:To evaluate the feasibility,safety and efficacy of transcathcter closure of ventricular septal defect(VSD)in patients with aortic valve prolapse(AVP)and mild aortic regurgitation(AR).Methods:Between January 2008 and July 2014,transcatheter closure of VSD was attempted in 65 patients.Results:The total intermediate closure successful rate in all subjects was 96.9%.During the perioperative period,no death,major bleeding,pericardial tamponade,occluder dislodgement,residual shunt or hemolysis occurred.Two procedures had been forced to suspend due to significant aggregation of device related aortic regurgitation,three cases of transient complete left bundle branch block occurred but did not sustain.At 1-year followup,no patients had residual shunts and complications.Furthermore,grade of residual AR were relieved in 61.9%(39/63)cases and degree of AVP were ameliorated in 36.5%(23/63)patients;Conclusions:Transcatheter closure VSD in selected patients with AVP and mild AR is technically feasible and highly effective.Long term safety and efficacy needs to be assessed. 展开更多
关键词 Transcatheter closure Ventricular septal defect Aortic valve prolapsed Aortic regurgitation
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Observation of efficacy on prolapse of lumbar intervertebral disc treated with body acupuncture and wrist-ankle acupuncture 认领 引用 被引量：7
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作者 何常春 周露 +1 位作者 欧阳世杰 李明 《World Journal of Acupuncture-Moxibustion》 CAS 2009年第3期31-36,共6页
Objective To observe the clinical effects of body acupuncture and wrist-ankle acupuncture on prolapse of lumbar intervertebral disc, Methods One hundred and eighty cases of prolapse of lumbar intervertebral disc were ... Objective To observe the clinical effects of body acupuncture and wrist-ankle acupuncture on prolapse of lumbar intervertebral disc, Methods One hundred and eighty cases of prolapse of lumbar intervertebral disc were randomly divided into body acupuncture and wrist-ankle acupuncture group （observation group） and simple body acupuncture group （control group）, 90 cases in each one. In observation group, body acupuncture was applied on Ahshi points of lumbar region, lumbar Jiájǐ （夹脊EX-B 2）, Dàchángshú（大肠俞 BL 25）, etc. and wrist-ankle acupuncture was applied on lower No. 4, 5 and 6 regions. In control group, simple body acupuncture was applied on the same points as observation group. Results The lumbar vertebral function and pain scale were improved in either group in comparison before and after treatment （P〈0.05）. Concerning pain improvement, the total effective rate was 95.6% in observation group, which was superior to that （86.7%） in control group （P〈0.05）. Concerning the improvement of lumbar vertebral function, the total effective rate was 90.0% in observation group and 93.3% in control group, without significant difference between two groups （P〉0.05）. Conclusion Combined therapy of body acupuncture and wrist-ankle acupuncture demonstrates apparent analgesia in prolapse of lumbar intervertebral disc. 展开更多
关键词 Prolapse of Lumbar Intervertebral Disc Acupuncture Therapy Wrist-Ankle Acupunc-ture Body Acupuncture
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Therapeutic effects of the TST36 stapler on rectocele combined with internal rectal prolapse 认领 引用 被引量：5
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作者 Jin Meng Zhi-Tao Yin +7 位作者 Ying-Yi Zhang Yong Zhang Xiu Zhao Qing Zhai De-Yu Chen Wei-Gang Yu Lei Wang Zhi-Gang Wang 《World Journal of Gastrointestinal Surgery》 SCIE 2021年第5期443-451,共9页
BACKGROUND The most common causes of outlet obstructive constipation(OOC)are rectocele and internal rectal prolapse.The surgical methods for OOC are diverse and difficult,and the postoperative complications and recurr... BACKGROUND The most common causes of outlet obstructive constipation(OOC)are rectocele and internal rectal prolapse.The surgical methods for OOC are diverse and difficult,and the postoperative complications and recurrence rate are high,which results in both physical and mental pain in patients.With the continuous deepening of the surgeon’s concept of minimally invasive surgery and continuous in-depth research on the mechanism of OOC,the treatment concepts and surgical methods are continuously improved.AIM To determine the efficacy of the TST36 stapler in the treatment of rectocele combined with internal rectal prolapse.METHODS From January 2017 to July 2019,49 female patients with rectocele and internal rectal prolapse who met the inclusion criteria were selected for treatment using the TST36 stapler.RESULTS Forty-five patients were cured,4 patients improved,and the cure rate was 92%.The postoperative obstructed defecation syndrome score,the defecation frequency score,time/straining intensity,and sensation of incomplete evacuation were significantly decreased compared with these parameters before treatment,and the differences were statistically significant(P<0.05).The postoperative anal canal resting pressure and maximum squeeze pressure in patients decreased compared with before treatment,and the differences were statistically significant(P<0.05).The initial and maximum defecation thresholds after surgery were significantly lower than those before treatment,and the differences were statistically significant(P<0.05).The postoperative ratings of rectocele,resting phase,and defecation phase in these patients were significantly decreased compared with those before treatment,and the differences were statistically significant(P<0.05).CONCLUSION The TST36 stapler is safe and effective in treating rectocele combined with internal rectal prolapse and is worth promoting in clinical work. 展开更多
关键词 TST36 stapler Rectocele Internal rectal prolapse Outlet obstructive constipation Longo obstructed defecation syndrome score Constipation
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