The Association Between Levator Ani Integrity and Postpartum Ano-Rectal Dysfunction: A Systematic Review.

Introduction And Hypothesis: Pregnancy and delivery are commonly associated with ano-rectal dysfunction. In addition, vaginal delivery may impact both the structure and functionality of the pelvic floor. Herein, we systematically reviewed the literature for the potential association between levator ani muscle (LAM) avulsion and ano-rectal function after childbirth.

Pelvic Floor Ultrasound Findings and Symptoms of Pelvic Floor Dysfunction During Pregnancy.

Introduction And Hypothesis: Pregnancy and childbirth predispose to pelvic floor dysfunction (PFD), coinciding with functional and anatomical changes in the pelvic floor. To some extent, these can be assessed by transperineal ultrasound (TPUS), yet the correlation between ultrasound findings and symptoms has not been well elucidated. We hypothesised that pregnant women with PFD would show different findings at TPUS.

Three-Dimensional Transperineal Ultrasound Assessment of the Anal Sphincter Immediately After Vaginal Birth: An Exploratory Study.

Objectives: To assess the feasibility of acquiring adequate transperineal ultrasound (TPUS) volumes of the anal sphincter (AS) immediately after vaginal birth, the reproducibility of its measurements, and detecting defects therein.

Methods: Secondary analysis of TPUS volumes of the AS, acquired immediately after vaginal birth with a transversely oriented convex probe. Two independent experts ranked off-line image quality as "inadequate," "adequate," or "ideal" using the Point-of-Care Ultrasound Image Quality scale.

Body image and pelvic floor dysfunction in pregnancy and postpartum: A prospective one-year follow-up cohort study.

Objective: To determine the prevalence of pelvic floor dysfunction (PFD) among pregnant women, their clustering and their association with body image disturbance (BID) up to 1 year postpartum.

Design: Monocentric prospective cohort study.

Setting: University Hospitals Leuven.

Safety and medium-term outcome of redo laparoscopic sacrocolpopexy: a matched case-control study.

Introduction And Hypothesis: In the case of recurrent apical prolapse following laparoscopic sacrocolpopexy (LSCP), one may consider a "redo" procedure. We hypothesized that redo LSCP may carry an increased complication risk and less favorable outcomes when compared with primary procedures.

Methods: This is a single-center, matched case-control (1:4) study, comparing all 39 women who had a redo LSCP and 156 women who had a primary LSCP for symptomatic apical prolapse between 2002 and 2020 with a minimum follow-up of 12 months.

Deflection of tandem archwire in a specific self-ligating metal bracket system: an in vitro study.

The aim of this study was to quantify the force exerted by tandem archwires in a specific system of passive self-ligating bracket. Forty-eight thermo-activated nickel-titanium orthodontic archwires were separated into four groups (n = 12): G1 - two .014" + .

Predictive factors for obstetric anal sphincter injury in primiparous women: systematic review and meta-analysis.

Objectives: The primary objective was to perform a systematic review of predictive factors for obstetric anal sphincter injury (OASI) occurrence at first vaginal delivery, with the diagnosis made by ultrasound (US-OASI). The secondary objective was to report on incidence rates of sonographic anal sphincter (AS) trauma, including trauma that was not clinically reported at childbirth, among the studies providing data for our primary objective.

Methods: We conducted a systematic search of MEDLINE, EMBASE, Web of Science, CINAHL, The Cochrane Library and ClinicalTrials.

VEGF overexpressed mesoangioblasts enhance urethral and vaginal recovery following simulated vaginal birth in rats.

Vaginal birth causes pelvic floor injury which may lead to urinary incontinence. Cell therapy has been proposed to assist in functional recovery. We aim to assess if intra-arterial injection of rat mesoangioblasts (MABs) and stable Vascular Endothelial Growth Factor (VEGF)-expressing MABs, improve recovery of urethral and vaginal function following simulated vaginal delivery (SVD).

Long-term Data on Graft-Related Complications After Sacrocolpopexy With Lightweight Compared With Heavier-Weight Mesh.

Objective: To estimate the long-term incidence and characteristics of graft-related complications, rate of reintervention for graft-related complications and prolapse, and subjective and anatomical outcomes after laparoscopic sacrocolpopexy with heavier-weight (more than 44 g/m2) compared with lightweight (28 g/m2) polypropylene mesh, the latter with resorbable poliglecaprone component.

Methods: We conducted a single-center study that compared two consecutive prospective cohorts of patients who were undergoing laparoscopic sacrocolpopexy for symptomatic stage 2 or greater cervical or vault prolapse, by using either heavier-weight polypropylene mesh or lightweight polypropylene mesh at a similar duration of follow-up. The primary outcome was the occurrence of graft-related complications and their nature.

The acute phase management of spinal cord injury affecting polytrauma patients: the ASAP study.

Background: Few data on the management of acute phase of traumatic spinal cord injury (tSCI) in patients suffering polytrauma are available. As the therapeutic choices in the first hours may have a deep impact on outcome of tSCI patients, we conducted an international survey investigating this topic.

Methods: The survey was composed of 29 items.

International Urogynecological Consultation (IUC): pathophysiology of pelvic organ prolapse (POP).

Introduction And Hypothesis: This manuscript is the International Urogynecology Consultation (IUC) on pelvic organ prolapse (POP) chapter one, committee three, on the Pathophysiology of Pelvic Organ Prolapse assessing genetics, pregnancy, labor and delivery, age and menopause and animal models.

Materials And Methods: An international group of urogynecologists and basic scientists performed comprehensive literature searches using pre-specified terms in selected biomedical databases to summarize the current knowledge on the pathophysiology of the development of POP, exploring specifically factors including (1) genetics, (2) pregnancy, labor and delivery, (3) age and menopause and (4) non-genetic animal models. This manuscript represents the summary of three systematic reviews with meta-analyses and one narrative review, to which a basic scientific comment on the current understanding of pathophysiologic mechanisms was added.

Perioperative management of severe brain injured patients.

Traumatic brain injury (TBI) is a leading cause of mortality and disability worldwide. Head injured patients may frequently require emergency neurosurgery. The perioperative TBI period is very important as many interventions done in this stage can have a profound effect on the long-term neurological outcome.

Automatic Extraction of Hiatal Dimensions in 3-D Transperineal Pelvic Ultrasound Recordings.

The aims of this work were to create a robust automatic software tool for measurement of the levator hiatal area on transperineal ultrasound (TPUS) volumes and to measure the potential reduction in variability and time taken for analysis in a clinical setting. The proposed tool automatically detects the C-plane (i.e.

Predictors for sexual dysfunction in the first year postpartum: A systematic review and meta-analysis.

Background: Pregnancy and childbirth increase the risk for pelvic floor dysfunction, including sexual dysfunction. So far, the mechanisms and the extent to which certain risk factors play a role remain unclear.

Objectives: In this systematic review of the literature we aimed to determine risk factors for sexual dysfunction in the first year after childbirth.

Obstetric risk factors for anorectal dysfunction after delivery: a systematic review and meta-analysis.

Introduction And Hypothesis: Pregnancy and childbirth are considered risk factors for pelvic floor dysfunction, including anorectal dysfunction. We aimed to assess the effect of obstetric events on anal incontinence and constipation after delivery.

Methods: We systematically reviewed the literature by searching MEDLINE, Embase and CENTRAL.

Pregnancy, labour and delivery as risk factors for pelvic organ prolapse: a systematic review.

Introduction: Pregnancy and childbirth are considered risk factors for pelvic organ prolapse (POP). The long latency between obstetric events and morbidity hinders the establishment of cause-effect relationships. Recently, intermediate outcomes such as organ descent and levator avulsion (LA) have been identified.

Systematic Review and Meta-Analysis on Hysterectomy by Vaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) Compared to Laparoscopic Hysterectomy for Benign Indications.

(1) Objective: We aimed to report an update of the systematic review and meta-analysis by Baekelandt et al. (2016). (2) Method: We followed PRISMA guidelines to perform this systematic review.

Prediction of neonatal coarctation of the aorta at fetal echocardiography: a scoring system.

Introduction: Coarctation of the aorta (CoA) is common and can lead to neonatal emergency. Despite its burden, antenatal detection of this condition remains inaccurate.

Objective: To evaluate the diagnostic performance of fetal echocardiography and to design a scoring system for risk stratification of CoA in suspected cases.

Effect of Short-Term Dietary Intervention and Probiotic Mix Supplementation on the Gut Microbiota of Elderly Obese Women.

Accumulating literature is providing evidence that the gut microbiota is involved in metabolic disorders, but the question of how to effectively modulate it to restore homeostasis, especially in the elderly, is still under debate. In this study, we profiled the intestinal microbiota of 20 elderly obese women (EO) at the baseline (T0), after 15 days of hypocaloric Mediterranean diet administered as part of a nutritional-metabolic rehabilitation program for obesity (T1), and after a further 15 days of the same diet supplemented with a probiotic mix (T2). Fecal samples were characterized by Illumina MiSeq sequencing of the 16S rRNA gene.

Exo-anal imaging of the anal sphincter: a comparison between introital and transperineal image acquisition.

Introduction And Hypothesis: Three-dimensional exoanal ultrasound imaging of the anal sphincter may be obtained transperineally with a convex probe, or at the introitus with a transvaginal probe. We hypothesised that introital acquisition would yield better quality and more reproducible evaluation.

Methods: We acquired three 3D volumes of the anal sphincter (one transperineal transverse with a 4- to 8-MHz convex probe and two introital with a 5- to 9-MHz probe in transverse and mid-sagittal view) in 20 representative women attending the gynaecology clinic.

Medium-term outcome of laparoscopic sacrocolpopexy using polivinylidene fluoride as compared to a hybrid polyglecaprone and polypropylene mesh: A matched control study.

Aim: To compare 2-year outcomes of laparoscopic sacrocolpopexy (LSCP) either with polyvinylidene fluoride (PVDF) or hybrid polypropylene containing a resorbable polyglecaprone (PP+ PG) mesh.

Materials And Methods: Retrospective audit on 105 consecutive patients undergoing LSCP a with PVDF-mesh (DynaMesh, FEG Textiltechniken), matched by prolapse stage and cervicopexy or vault suspension to 105 controls undergoing LSCP with a hybrid PP + PG-mesh (Ultrapro, Ethicon). Patients are part of an ongoing prospective study.

Does flatus incontinence matter?

Introduction And Hypothesis: This study aimed to determine whether incontinence to flatus is associated with women's bother in a symptomatic population and with sonographically diagnosed external anal sphincter (EAS) trauma.

Methods: This is a retrospective study of women attending a tertiary urogynecological unit between May 2013 and November 2015. Baseline evaluation included a standardized interview with St.

Monitoring infants by automatic video processing: A unified approach to motion analysis.

A unified approach to contact-less and low-cost video processing for automatic detection of neonatal diseases characterized by specific movement patterns is presented. This disease category includes neonatal clonic seizures and apneas. Both disorders are characterized by the presence or absence, respectively, of periodic movements of parts of the body-e.

Neonatal seizure automatism and human inborn pattern of quadrupedal locomotion.

Seizures in newborns do not always show a clear electro-clinical correlation. The real epileptic nature of some stereotyped rhythmic movements, included in the 'subtle seizures' and considered as brainstem release phenomena, is still debated. We report a brain injured newborn, who displayed several episodes of repetitive limb movements.

Optimizing Detection Rate and Characterization of Subtle Paroxysmal Neonatal Abnormal Facial Movements with Multi-Camera Video-Electroencephalogram Recordings.

Objectives We retrospectively analyze the diagnostic accuracy for paroxysmal abnormal facial movements, comparing one camera versus multi-camera approach. Background Polygraphic video-electroencephalogram (vEEG) recording is the current gold standard for brain monitoring in high-risk newborns, especially when neonatal seizures are suspected. One camera synchronized with the EEG is commonly used.