Does parity impact obstructed defecation in women with normal anorectal anatomy?

Introduction And Hypothesis: Obstructed defecation (OD) is often associated with trauma to pelvic connective tissue and nerves sustained during pregnancy and childbirth. Although there are multiple potential etiologies of defecatory dysfunction, the pathophysiology of this symptom complex is not well understood. The purpose of this study is to determine the role of parity in the development of obstructed defecatory symptoms in women with normal anorectal anatomy in a search for evidence of a presumptive neuropathic effect of pregnancy and childbirth.

Imaging Characteristics of Episiotomy Scars on Translabial Ultrasound: An Observational Study.

Introduction: Episiotomy has been purported to protect the anal sphincter from injury; efficacy is, however, disputed. Correct execution of episiotomy may have substantial implications. We aimed to describe the characteristics of episiotomy scars on translabial ultrasound (TLUS).

Is perineal hypermobility an independent predictor of obstructive defecation?

Introduction And Hypothesis: Symptoms of obstructed defecation (OD) and anatomical abnormalities of the posterior compartment are prevalent in urogynecological patients. The aim of this study was to determine whether perineal hypermobility is an independent predictor of OD, as is the case for rectocele, enterocele and rectal intussusception.

Methods: This is a retrospective study of 2447 women attending a tertiary urodynamic center between September 2011 and December 2016.

Does Vaginal Parity Alter the Association Between Symptoms and Signs of Pelvic Organ Prolapse?

Objectives: This study aimed to investigate whether the number of vaginal births a woman has alters the association between symptoms and signs of pelvic organ prolapse.

Methods: In this retrospective study, we investigated data on 1748 women seen between April 2012 and January 2016. To elucidate whether the number of vaginal births is a confounder of this relationship, we used receiver operating characteristic statistics to investigate the association between symptoms and signs of prolapse in women of different vaginal parity.

Anal sphincter imaging: better done at rest or on pelvic floor muscle contraction?

Introduction And Hypothesis: Exo-anal ultrasound imaging of the anal sphincter is usually undertaken on pelvic floor muscle contraction (PFMC) as this seems to enhance tissue discrimination. Some women are unable to achieve a satisfactory PFMC, and in this situation, the sphincter is assessed at rest. We aimed to determine whether sphincter imaging at rest is inferior to imaging on PFMC.

Parity and anal sphincter trauma.

Introduction And Hypothesis: Obstetric anal sphincter injury (OASI) is a form of maternal trauma secondary to vaginal birth. Women with a history of OASI are deemed to be at a higher risk of recurrence. However, it is unclear if multiparity is associated with higher prevalence.

Should Genital Hiatus/Perineal Body Be Measured at Rest or on Valsalva?

Objective: Genital hiatus (Gh) and perineal body (Pb) are part of the Pelvic Organ Prolapse Quantification assessment system, but it is unclear whether measurements should be taken at rest or on Valsalva. This study was designed to assess the predictive value of Gh and Pb measurements obtained at rest and on Valsalva for signs and symptoms of pelvic organ prolapse (POP).

Methods: This is a retrospective study involving 416 women who presented to a tertiary urogynecology unit with symptoms of pelvic floor dysfunction.

Impact of subsequent pregnancies on pelvic floor functional anatomy.

Introduction And Hypothesis: Vaginal childbirth clearly has an effect on pelvic floor anatomy, and pregnancy itself also likely plays a role. This study investigated the effects of consecutive pregnancies by comparing pelvic organ support and function in urogynecological patients delivered by cesarean section (CS) only.

Methods: This was a retrospective study using 161 archived data sets of urogynecological patients delivered exclusively by CS presenting with symptoms of pelvic floor dysfunction between 2007 and 2015.

Correlations between Sonographic and Urodynamic Findings after Mid Urethral Sling Surgery.

Purpose: We studied correlations between sonographic and urodynamic findings after suburethral sling surgery.

Materials And Methods: This retrospective study was done in 141 women who underwent multichannel urodynamic testing and translabial 4-dimensional ultrasound after suburethral sling surgery between 2006 and 2016. We determined the sling-pubis gap, ie the distance between the sling and the inferior posterior margin of the pubic symphysis, during the Valsalva maneuver and the urethral motion profile.

Digitation to Void: What Is the Significance of This Symptom?

Objective: Digitation to void is defined as the need to apply manual pressure on the perineum or the vagina to assist with voiding. It has been associated with prolapse; however, there is little objective data concerning this symptom. Our aim was to determine the correlation between digitation to void, symptoms and signs of pelvic organ prolapse (POP), and urodynamic data.

Pelvic organ prolapse: does hormone therapy use matter?

Objective: To determine the effect of hormone therapy (HT) use on pelvic organ support.

Methods: A retrospective observational study involving postmenopausal women with pelvic floor dysfunction attending a tertiary urogynecology center between January 2012 and March 2015. All underwent a clinical examination including International Continence Society Pelvic Organ Prolapse Quantification and 4D translabial ultrasound imaging.

Prolapse assessment supine and standing: do we need different cutoffs for "significant prolapse"?

Introduction And Hypothesis: Translabial ultrasound (TLUS) has shown good correlations between clinical examination and imaging findings in the supine position, and limits of normality have been described. This is not the case for imaging in the standing position. This study was designed to test the hypothesis that different cutoff values are required for imaging in the standing position.