Young-GRAPPA at the Annual GRAPPA Meeting: Presentation of a New Group Within GRAPPA and Its Vision.

At the 2021 Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) annual meeting, a separate group was created (Young-GRAPPA) to address the challenges of young researchers and physicians beginning their careers. This paper presents the initial organizational framework and different components and aims of this group. We were able to enroll over 50 young researchers as a result of this meeting.

The HelpED study: agreement and impact of the erection hardness score on sexual function and psychosocial outcomes in men with erectile dysfunction and their partners.

Introduction: The HelpED study assessed men with erectile dysfunction (ED) treated with a phosphodiesterase type 5 (PDE5) inhibitor and their female partner in a community setting.

Aim: To examine agreement in Erection Hardness Score (EHS) in patients and partners; to assess impact of EHS changes on other sexual health outcomes and behaviors.

Methods: At baseline and follow-up 2 to 4 months later, men in a stable heterosexual relationship who had newly diagnosed or untreated ED (≥6 months) completed the single-item EHS, the International Index of Erectile Function questions 4 and 5 (assessing erection maintenance), the Self-Esteem And Relationship (SEAR) questionnaire, and a modified Quality of Life domain of the Sexual Life Quality Questionnaire (mSLQQ-QOL).

[Laparoscopic colorectal surgery--SILS, robots, and NOTES].

Single incision laparoscopic surgery resection of colon is feasible, but so far evidence of benefit compared to standard laparoscopic technique is lacking. In addition to robot-controlled camera, there is only one robot system on the market capable of performing laparoscopic surgery. The da Vinci robot may contribute to making complex laparoscopic procedures easier to perform, but the system is costly in purchase and maintenance.

Understanding the effects of sildenafil treatment on erection maintenance and erection hardness.

Introduction: Erectile dysfunction (ED) is defined as the inability to attain and/or maintain penile erection sufficient for satisfactory sexual performance. Although intuitively related, the link between erection hardness and erection maintenance has not been formally established and quantified.

Aim: To understand the components of erection maintenance through statistical modeling.

Clinical, physiological and radiological assessment of rectovaginal septum reinforcement with mesh for complex rectocele.

Background: Rectocele can be part of a more complex rectal prolapse syndrome including rectal intussusception and enterocele. This reflects insufficiency at different levels of support in the posterior pelvic compartment. A new technique involving reinforcement of the rectovaginal septum with mesh by a combined laparoscopic and perineal approach was evaluated.

Laparoscopic totally stapled entero-enterostomy: a safe and reproducible new technique.

Background: Laparoscopic gastric bypass for morbid obesity is a technically demanding procedure, partially because of the necessity to construct two anastomoses. In this study, a new technique to perform the entero-enterostomy is presented.

Methods: We evaluated the procedure in a consecutive series of 100 patients who underwent laparoscopic gastric bypass.

Intracorporeal rectal stapling following laparoscopic total mesorectal excision: overcoming a challenge.

Background: Division of the rectum following total mesorectal excision (TME) using intracorporeal stapling devices is technically difficult due to their width and limited roticulation. More than one cartridge is often required and resultant wedging of the stump may be associated with an appreciable leak rate.

Methods: Three-dimensional reconstruction was performed of CT and MRI images from the lower abdomen of six patients undergoing laparoscopic TME using the Amira software environment.

Long-term outcome of laparoscopic ventral rectopexy for total rectal prolapse.

Background: Postoperative constipation is a common problem with most mesh suspension techniques used to correct rectal prolapse. Autonomic denervation of the rectum subsequent to its complete mobilization has been suggested as a contributory factor. The aim of this study was to assess the long-term outcome of patients who underwent a novel, autonomic nerve-sparing, laparoscopic technique for rectal prolapse.

Obstructed defecation.

Background: In the last decade our understanding of pelvic floor function and dysfunction has improved significantly. A more rational diagnostic and therapeutic approach is now possible for the group of patients with constipation due to obstructed defecation (OD).

Methods: The review is based on a literature search using the PubMed database focusing mainly on recent literature addressing the subject.

Clinical and manometric effects of combined external beam irradiation and brachytherapy for anal cancer.

This study evaluates anorectal function after combined tele- and brachytherapy for anal cancer using manometric measurements and a standardized questionnaire. Eight patients received 44 +/- 3 Gy external beam radiation followed by 20 +/- 4 Gy interstitial brachytherapy with iridium-192. Patients were examined 43 months (range 25-83) after therapy.

The trigger for rectal filling sensation.

In order to evaluate whether rectal volume, weight or pressure is the main trigger for rectal sensation, their respective values were determined at each of the rectal filling sensation thresholds (first, constant, urge, maximum) in 12 adult control subjects. The rectal balloon was filled at 60 ml/min in sitting position using water (twice), air and mercury consecutively. Pressure values were corrected for the elastic properties of the balloon, while the volume of inflated air was recalculated taking into account the prevalent rectal pressure and temperature.

Fecal incontinence: indications for repairing the anal sphincter.

Incontinent patients should be comprehensively investigated by objective tests, especially manometry, continence tests, and electromyography. Manometry can be used to predict the functional outcome and to calibrate the sphincter repair. Pure anatomical defects of the anal and pelvic musculature deserve surgical correction with or without overlapping the muscle ends.

The internal anal sphincter can not close the anal canal completely.

We determined the maximum closing capability of the internal anal sphincter muscle ring in vitro and in vivo. The internal sphincter, 4 to 6 mm thick, cannot close the anal canal hermetically, not even during maximal contraction. The blood-filled anal cushions have to fill up an intrasphincteric gap of at least 7 to 8 mm in diameter.