Rectocele repair with stapled transvaginal rectal resection.

Background: Constipation is a clinical symptom in patients suffering from slow transit and/or obstructed defecation. Proper treatment requires the identification of all associated disorders and the quantification of symptoms. Rectocele can cause the symptoms of obstructed defecation syndrome (ODS).

Combined partial fistulectomy and electro-cauterization of the intersphincteric tract as a sphincter-sparing treatment of complex anal fistula: clinical and functional outcome.

Background: The aim of this study was to report a simple, effective and safe procedure, associated with minimal risk of incontinence and recurrence, for treating complex anal fistulas.

Methods: This was a prospective study of 53 consecutive patients with complex anal fistulas. The technique used included excision of the distal part of the fistula tract down to the external anal sphincter and electro-cauterization of the intersphincteric part of the tract with simple closure of the internal opening.

On the etiology of the electric activity of the external anal and urethral sphincters.

Unlabelled: In a previous study, the external anal sphincter (EAS) in dogs, known to consist of skeletal muscle fibers, was proved to contain bundles of smooth muscle fibers in between as well.

Objective: Cause of electric activity in the external anal and urethral sphincters is not known; the current study investigated this point.

Material And Methods: Slices from external anal and urethral sphincters of 21 cadavers (12 male, 9 female).

Tunica albuginea reefing: a novel technique for the treatment of erectile dysfunction.

Background: "Tunica albuginea (TA) reefing" is a modification of Shafik's "TA overlapping" operation. Both techniques are based on the fact that in venogenic erectile dysfunction patients, the TA exhibits degenerative and atrophic collagen and elastic fibers causing its subluxation and flabbiness. This had led to loss of the veno-occlusive mechanism of the TA and venous leakage during erection.

Effect of severe stress on the gastric motor activity: canine study of mechanism of action.

Background: Increased gastric motility was observed during restraint stress in animals; however, mechanism of action could not be traced in literature. We investigated the hypothesis that high levels of stressful cutaneous stimuli induce increase of gastric motor activity through a reflex action.

Methods: Gastric tone (GT) was assessed in 14 dogs by barostat system consisting of balloon-ended tube connected to strain gauge and air-injection system.

Percutaneous perineal electrostimulation induces erection: clinical significance in patients with spinal cord injury and erectile dysfunction.

Objectives: Approximately one third to one half of the penis is embedded in the pelvis and can be felt through the scrotum and in the perineum. The main arteries and nerves enter the penis through this perineal part of the penis, which seems to represent a highly sensitive area. We investigated the hypothesis that percutaneous perineal stimulation evokes erection in patients with neurogenic erectile dysfunction.

Vaginal response to clitoral stimulation: identification of the clitorovaginal reflex.

Objective: To investigate the hypothesis that glans clitoris (GC) penile buffeting effects contraction of the vaginal musculature and seems to increase arousal of the penis during coitus.

Study Design: The response of the vaginal wall to GC electrical and mechanical stimulation was recorded in 26 healthy women (aged 36.8 +/- 6.

Study of the response of the penile corporal tissue and cavernosus muscles to micturition.

Background: The reaction of the corpora cavernosa (CC), the corpus spongiosum (CS), the bulbocavernosus (BCM) and ischiocavernosus (ICM) muscles to passage of urine through the urethra during micturition is not known. We investigated the hypothesis that the passage of urine through the urethra stimulates the corporal tissue and cavernosus muscles.

Methods: In 30 healthy men (mean age 42.

Inguinal canal dilatation: a novel technique for the repair of failed testicular descent despite hormonal treatment.

Treatment of the undescended testicle (UT) after it failed to descend on hormonal therapy is surgical. Spermatic cord elongation may impair testicular function, particularly in cases in which cord integuments or veins have to be divided to provide an extra cord length. A factor that might impede testicular descent is presence of a narrowed or obliterated inguinal canal.

Study of the effect of ileal distension on the motor activity of the jejunum, and of jejunal distension on the motor activity of the ileum.

Background/aims: The effect of ileal distension on the jejunal motor activity and ofjejunal distension on the ileal motility have been poorly addressed in the literature. We investigated the hypothesis that distension of either ileum or jejunum would affect the motile activity of the other.

Methodology: Response of jejunal pressure to ileal balloon distension and of ileal pressure to jejunal distension in increments of 2 mL of normal saline were recorded in 18 dogs.

A study of the effect of straining on the cavernosus muscles: identification of 'straining-cavernosus reflex' and its clinical significance.

Bulbo/ischiocavernosus muscles (BCM, ICM) were found to contract on straining. We investigated the hypothesis that straining effects cavernosus muscles' contraction through a reflex action. The response of the BCM and ICM electromyographic (EMG) activity to increased intra-abdominal pressure (straining) as recorded by the intravesical pressure was registered in 32 healthy volunteers (age 39.

Electromyographic study of ejaculatory mechanism.

Cavernosus muscle (CM), seminal vesicle (SV) and vasal ampullary (VA) contractions at ejaculation are said to be reflex mechanisms (ejaculatory reflex), which have been scarcely dealt with in the literature. We investigated the hypothesis that contraction of the CMs, SVs and VA at ejaculation is a reflex action. The electromyographic (EMG) activity of CM, SV and VA during ejaculation was recorded in 28 healthy men.

The electromyographic activity of the external and internal urethral sphincters and urinary bladder on vaginal distension and its role in preventing vaginal soiling with urine during sexual intercourse.

Background/aim: We investigated the hypothesis that external (EUS) and internal (IUS) urethral sphincters and urinary bladder (UB) respond to penile thrusting (PT) of vagina in a way that prevents urinary leakage during coitus.

Methods: Vaginal condom was inflated with air in increments of 50-300 ml and EMG of EUS and IUS and vaginal pressure were recorded; test was repeated after anesthetization of vagina, UB, EUS, and IUS.

Results: Vaginal distension effected reduction of vesical pressure but increase of IUS EMG until the 150 ml distension was reached, beyond which more vaginal distension caused no further effect; EUS EMG showed no response.

Effect of urethral stimulation on vesical contractile activity.

Background: We investigated the hypothesis that urethral stimulation effects vesical contraction.

Methods: Vesical pressure response to urethral balloon distension with normal saline in increments of 1 mL was recorded in 26 healthy volunteers (17 men, 9 women; mean age, 36.9 +/- 9.

Physiological considerations of the morphologic changes of the testicles during erection and ejaculation: a canine study.

Purpose: We investigated the hypothesis that testicles and scrotal skin undergo morphologic changes that would serve the mechanism of erection and ejaculation.

Materials And Methods: Testicular and scrotal skin changes during erection and ejaculation were studied in 9 dogs. Testicular volume was measured by ultrasound, testicular temperature by digital thermometer and testicular vascularity by color duplex Doppler ultrasonography.

Duodeno-jejunal junction: a histoanatomical study with the concept of the existence of an "anatomical" sphincter.

Background: Duodenojejunal junction (DJJ) pressure decreased on duodenal contraction and increased on jejunal contraction. These findings postulated potential existence of anatomical sphincter at DJJ.

Methods: DJJ was studied by direct dissection in 34 cadavers and histologically in 24.

Effect of micturition on clitoris and cavernosus muscles: an electromyographic study.

We investigated the hypothesis that passage of urine through urethra stimulates corporal tissue and cavernosus muscles. Electromyographic (EMG) activity of corpora cavernosa (CC), bulbocavernosus muscle (BCM), and ischiocavernosus muscle (ICM) was recorded in 27 healthy women before and during micturition. These tests were repeated after individual anesthetization of urethra, corporal tissue, and cavernosus muscles.

The effect of gastric overfilling on the pharyngo-esophageal and lower esophageal sphincter: a possible factor in restricting food intake.

Background: How afferent activity in the gut achieves the required ingestion control has not been established. The authors hypothesized that gastric overdistension effects an increase in pharyngo-esophageal and lower esophageal sphincter activity aimed at inhibiting ingestion.

Material/methods: The study comprised 16 mongrel dogs.

On the pathogenesis of penile venous leakage: role of the tunica albuginea.

Background: Etiology of venogenic erectile dysfunction is not exactly known. Various pathologic processes were accused but none proved entirely satisfactory. These include presence of large venous channels draining corpora cavernosa, Peyronie's disease, diabetes and structural alterations in fibroblastic components of trabeculae and cavernous smooth muscles.

Duodeno-jejunal junction dyssynergia: description of a novel syndrome.

Aim: To investigate the hypothesis that duodeno-jejunal dyssynergia existed at the duodeno-jejunal junction.

Methods: Of 112 patients who complained of epigastric distension and discomfort after meals, we encountered nine patients in whom the duodeno-jejunal junction did not open on duodenal contraction. Seven healthy volunteers were included in the study.

Effect of cooling on the rectal tone.

Objectives: It has been claimed that recognizable organized sensory nerve endings could not be detected in the rectal wall. Hence the identification of cold receptors sensitive to cold temperature in the rectal wall has so far not been reported in the literature. We investigated the hypothesis that rectal cooling effected an increase of the rectal tone.

Electromyographic activity of the anterolateral abdominal wall muscles during rectal filling and evacuation.

Background: The role of the anterolateral abdominal wall muscles (AAWMs) at defecation has not received sufficient attention in the literature. We investigated the hypothesis that the AAWMs exhibit increased electromyographic (EMG) activity on rectal distension, which presumably assists in rectal evacuation.

Materials And Methods: The effect of rectal balloon distension on the AAWMs EMG and on anal and rectal pressure was examined in 23 healthy volunteers (37.

Study of the duodenal contractile activity during antral contractions.

Aim: To investigate the hypothesis that duodenal bulb (DB) inhibition on pyloric antrum (PA) contraction is reflex.

Methods: Balloon (condom)-tipped tube was introduced into 1(st) duodenum (DD) and a manometric tube into each of PA and DD. Duodenal and antral pressure response to duodenal and then PA balloon distension with saline was recorded.

Physiologic basis of digital-rectal stimulation for bowel evacuation in patients with spinal cord injury: identification of an anorectal excitatory reflex.

Background And Purpose: Although advances in rehabilitation practices, pharmacology, and surgery offer new bowel program alternatives, digital-rectal stimulation is still utilized to facilitate defecation in patients with spinal cord injury (SCI). We speculated that defecation induced by such a technique is mediated through a reflex mechanism.

Methods: The study comprised 18 healthy volunteers (10 men, 8 women, mean age 36.