Comparison of clinical outcomes between remodified Hanley procedure and modified Hanley procedure for high complex horseshoe fistula: a retrospective study.

Background: Treating high horseshoe anal fistula (HHAF) with the modified Halley procedure (MHP) often falls short when focusing solely on deep postanal space (DPAS) drainage. Our study underscores the significance of addressing deep posterior intersphincteric space (DPIS) drainage, prompting MHP modifications.

Methods: We studied consecutive patients with HHAF treated with either MHP or remodified-MHP (Re-MHP) at Ningbo Medical Center of Lihuili Hospital from January 2018 to December 2021.

Results at one year of the TROPIS technique in the treatment of complex anal fistula.

Introduction: It is a priority to find surgical techniques that guarantee acceptable healing rates without sequelae in the treatment of complex anal fistula. The concept of the deep intersphincteric space as the origin of perianal sepsis has provided a new perspective, allowing the emergence of techniques such as TROPIS (Transanal Opening of Intersphincteric Space), with few published series to date. The aim of this study is to evaluate the healing rate and complications one year after the TROPIS technique as a treatment for complex anal fistula without hospitalization.

Baseline Anal Sphincter Elastance May Predict Long-Term Outcomes of Sacral Neuromodulation for Fecal Incontinence.

Introduction: Anal acoustic reflectometry (AAR), a novel test of anal sphincter function, was shown to predict a successful trial phase of sacral neuromodulation (SNM) for fecal incontinence. This follow-up study aims to explore if AAR can also predict short- and long-term SNM outcomes at less than and more than 5 y, respectively.

Methods: Outcome data were reviewed from a prospectively managed database.

Urge fecal incontinence: are intramural rectal injections of botulinum toxin a long-term treatment option?

Background And Aims: Unsuccessful first-line conservative treatments for managing fecal incontinence (FI) lead to considering predominantly invasive options, posing challenges in terms of cost and patient acceptance of benefit/risk ratio. Recent data from a prospective randomized study have highlighted intramural rectal botulinum toxin (BoNT/A) injection as a promising minimally invasive alternative for urge FI, demonstrating efficacy at 3 months but lacking long-term evidence. This study aimed to evaluate the sustained efficacy and injection frequency of intramural rectal BoNT/A injection in the treatment of urge FI.

A Rare Case of Acute Aortic Occlusion Mimicking Cauda Equina Syndrome in a Patient With Inflammatory Bowel Disease.

Acute aortic occlusion (AAO) is a rare and life-threatening condition, mostly secondary to acute thrombosis or embolism. It usually presents as bilateral lower limb ischemia; however, in rare cases, spinal cord infarction might coexist, mimicking cauda equina syndrome. We present a rare case of AAO by saddle embolism of a thoracic aortic mural thrombus.

Association between blood heavy metals and fecal incontinence in American adults: A population-based study.

Background: Previous studies have revealed the impact of heavy metals (HMs) on gut microbiota and intestinal structure. However, the relationship between HMs and fecal incontinence (FI) remains unclear. Therefore, this study aims to evaluate the association between blood HMs exposure and FI.

Systemic sclerosis-related fecal incontinence: a scoping review focusing on a neglected manifestation.

Objectives: This scoping-review sought to summarize the current knowledge on the epidemiology, pathogenesis, clinical presentation, and the investigations that may help characterize faecal incontinence (FI) in patients with systemic sclerosis (SSc).

Methods: The planned scoping review was based on the methodological framework proposed by Arksey & O'Malley.Two databases were screened: PubMed (Medline), (webofSciences), data extraction was performed using a predefined template.

Missed Opportunities: A Mixed-Methods Assessment of Disparities in Treatment for Fecal Incontinence.

Importance: Previous work identified racial disparities in access to fecal incontinence (FI) treatments. However, less is known about patient perspectives of these barriers.

Objectives: This study assessed differences in FI symptom severity and treatment utilization between Black and White patients.

A case of lead migration after sacral neuromodulation with erosion into the rectum.

We present a case of a 73-year-old female with medication refractory overactive bladder treated with the InterStim® sacral neuromodulation device. Five months post implantation she developed drainage over the lead site and rectal bleeding. Evaluation identified lead migration with rectal perforation requiring surgical removal of the battery and lead.

Sarcopenia in Women with Anorectal Dysfunctions-A Female Sarcopelvic Study.

Anorectal dysfunctions (ARDs) include fecal incontinence (FI) and functional defecation disorders (FDDs). The pelvic floor muscles play a central role in the physiology of continence and defecation. We aimed to investigate the prevalence of sarcopenia in a female group with anorectal dysfunctions and compare them with a healthy female age-matched group.

Local excision for middle-low rectal cancer after neoadjuvant chemoradiation: A retrospective study from a single tertiary center.

Background: Rectal cancer has become one of the leading malignancies threatening people's health. For locally advanced rectal cancer (LARC), the comprehensive strategy combining neoadjuvant chemoradiotherapy (NCRT), total mesorectal excision (TME), and adjuvant chemotherapy has emerged as a standard treatment regimen, leading to favorable local control and long-term survival. However, in recent years, an increasing attention has been paid on the exploration of organ preservation strategies, aiming to enhance quality of life while maintaining optimal oncological treatment outcomes.

Modifiable psychological factors are associated with clusters of pain, fatigue, faecal incontinence and IBS-type symptoms in inflammatory bowel disease: a latent profile analysis.

Background: Inflammatory bowel disease (IBD) causes fatigue, pain and faecal urgency/incontinence symptoms. Identifying symptom profile subgroups and related psychological correlates might enable earlier intervention and more effective tailored treatment pathways.

Methods: This study was nested within a randomised controlled trial of a digital symptom intervention for people with IBD (n=780).

A new approach to repair recurrent vescicourethral anastomotic strictures after radical prostatectomy: The use of prerectal access.

Background: Vesicourethral anastomosis stenosis (VUAS) is a well-known complication of prostate cancer treatments, observed in up to 26% of the cases after radical prostatectomy. Conservative management, with single or even repeated transurethral dilation or endoscopic incision of the stenosis, is successful in many cases, but up to 9% of patients are destined to fail after endoscopic treatment. In these cases, a revision of the vesicourethral anastomosis is necessary and can be realized with different surgical approaches.

Comparison of Complications and Outcomes of Very Low Anterior Resection (VLAR) Versus Intersphentric Resection (ISR) In Patients with Rectal Cancer.

Background: Colorectal cancer is a cancer that starts in the colon or rectum, which are part of the digestive system. Intersphincteric resection (ISR) and very low anterior resection (VLAR) are surgical procedures used in rectal malignancy. We aimed to compare postoperative complications and recurrence after VLAR and ISR techniques in patients with rectal cancer.

Management of Fecal Incontinence: Surgical Treatment Options.

Background: Fecal incontinence (FI) is a frequent, often underestimated, health issue in adults. Its treatment is primarily nonsurgical. Only if conservative options fail to result in adequate symptom reduction should surgery be considered.

Management of Fecal Incontinence: Etiology, Diagnostic Approach, and Conservative Therapy.

Background: Fecal incontinence is a common problem especially in the elderly resulting in a reduced quality of life.

Summary: The etiology of fecal incontinence is often multifactorial with little options for a causal therapy. The mechanisms causing incontinence can be detected by sophisticated methods in most of the patients.

Single Incision Laparoscopic Surgery for Malone Antegrade Continent Enema: Optimizing Outcomes in Pediatric Bowel Management.

Background: Malone antegrade continence enemas (MACE) are increasingly being used to manage severe constipation and fecal incontinence in children. Despite advances in minimally invasive pediatric colorectal surgery, single-incision laparoscopic surgery (SILS) for MACE creation remains relatively unexplored. This study, featuring the largest cohort to date, evaluates the feasibility, safety, and clinical outcomes of SILS MACE creation in children.

Adaptation of the German language version of the QUAlity of life assessment of spina bifida for adults (QUALAS-A-G).

Introduction: Spina bifida (SB) affects almost all activities in daily life and therefore also health-related quality of life (HRQOL). To assess the HRQOL of adults with SB, a self-reported QUAlity of Life Assessment of Spina bifida in Adults (QUALAS-A) was validated in English. The purpose of this study was to develop and validate a German version of QUALAS-A.

Association of eating behavior with symptoms of pelvic floor disorders in middle-aged women: An observational study.

Background: Estrogen deficiency during menopause, aging, reproductive history, and factors increasing intra-abdominal pressure may lead to structural and functional failure in the pelvic floor. Lifestyle choices, such as eating behavior, may contribute to pelvic floor disorders.

Objectives: The objective of the study was to investigate associations of eating behavior with symptoms of pelvic floor disorders, that is, stress urinary incontinence, urgency urinary incontinence, fecal incontinence, and constipation or defecation difficulties among middle-aged women.

Efficacy of anal duct ligation and muscle closure: A novel sphincter-preserving surgical technique for fistula-in-ano.

Aim: Although various sphincter-preserving techniques exist for treating anal fistulas, none have demonstrated clear superiority. Therefore, the aim of this study was to introduce a novel sphincter-preserving technique for anal duct ligation and muscle closure (ALMC) and analyse its perioperative outcomes.

Method: The data for patients who underwent ALMC for fistula-in-ano at Seoul Song Do Hospital between 2009 and 2023 were retrospectively reviewed.

High-Intensity Laser Therapy - An Option for Managing the Pain in Anal Fissures.

Anal fissures (AFs) are a prevalent pathology. Although internal lateral sphincterotomy is still the gold-standard surgery for treating chronic AFs, this procedure is associated with a considerable risk of anal incontinence. This study describes an alternative and minimally invasive technique for treating AFs using photobiomodulation and a high-power diode laser-fissure treatment (LFT) and highlights initial results pertaining to pain.

Diagnostic accuracy of intraoperative pelvic autonomic nerve monitoring during rectal surgery: a systematic review.

Purpose: Anorectal and urogenital dysfunctions are common after rectal surgery and have a significant impact on quality of life. Intraoperative pelvic autonomic nerve monitoring (pIONM) has been proposed as a tool to identify patients at risk of these functional sequelae. This systematic review aims to evaluate the diagnostic accuracy of pIONM in detecting anorectal and urogenital dysfunction following rectal surgery.

Tailored sacroplasty for sacral fracture secondary to an epileptic seizure.

Background: Sacral fractures causing neurological deficits secondary to epileptic seizures are very rare. They are traditionally treated by laminectomy and sacral fixation. However, minimally invasive techniques such as sacroplasty offer more limited surgery with decreased morbidity.