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Management of fourth degree obstetric perineal tear without colostomy using non - stimulated gracilis - our experience over eleven years
BACKGROUND: Although gracilis muscle transposition for faecal incontinence has been well-described method, its literature for use in obstetric perineal tear without colostomy is sparse. In this study, we have tried to analyse its use in fourth-degree obstetric perineal tears. PATIENTS AND METHODS: A...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4878240/ https://www.ncbi.nlm.nih.gov/pubmed/27274119 http://dx.doi.org/10.4103/0970-0358.182236 |
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author | Kulkarni, Jiten Patil, Anuradha J. Musande, Bhaskar Bhamare, Abhishek B. |
author_facet | Kulkarni, Jiten Patil, Anuradha J. Musande, Bhaskar Bhamare, Abhishek B. |
author_sort | Kulkarni, Jiten |
collection | PubMed |
description | BACKGROUND: Although gracilis muscle transposition for faecal incontinence has been well-described method, its literature for use in obstetric perineal tear without colostomy is sparse. In this study, we have tried to analyse its use in fourth-degree obstetric perineal tears. PATIENTS AND METHODS: A total of 30 patients with recto-vaginal fistula with faecal incontinence secondary to obstetric perineal tear were retrospectively studied between February 2003 and May 2014. The recto-vaginal fistula was explored, dissected and identification of sphincters was done using muscle stimulator. Fistula closure was done followed by sphincter repair, vaginal tightening procedure and single gracilis transposition. None of the patients had covering colostomy. Faecal incontinence was assessed pre- and post-operatively by digital rectal examination (single examiner), Park's score and Corman's score in all cases and using barium hold and transperineal ultrasonography, manometric studies in a few cases. The outcome was measured at an average follow-up of 8.8 months (7–24 months). RESULTS: As per Park's score 26 patients had Grade I continence, two had Grade II and two patients had Grade III continence. Corman's score improved from fair to excellent in 26 patients. The patients in whom manometry was performed showed a remarkable rise in both resting and squeeze pressures. Two patients developed post-operative infections in upper 1/3 thigh incision site and three patients at gluteal region scar site. CONCLUSION: Satisfactory continence following gracilis muscle could be achieved. |
format | Online Article Text |
id | pubmed-4878240 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-48782402016-06-07 Management of fourth degree obstetric perineal tear without colostomy using non - stimulated gracilis - our experience over eleven years Kulkarni, Jiten Patil, Anuradha J. Musande, Bhaskar Bhamare, Abhishek B. Indian J Plast Surg Original Article BACKGROUND: Although gracilis muscle transposition for faecal incontinence has been well-described method, its literature for use in obstetric perineal tear without colostomy is sparse. In this study, we have tried to analyse its use in fourth-degree obstetric perineal tears. PATIENTS AND METHODS: A total of 30 patients with recto-vaginal fistula with faecal incontinence secondary to obstetric perineal tear were retrospectively studied between February 2003 and May 2014. The recto-vaginal fistula was explored, dissected and identification of sphincters was done using muscle stimulator. Fistula closure was done followed by sphincter repair, vaginal tightening procedure and single gracilis transposition. None of the patients had covering colostomy. Faecal incontinence was assessed pre- and post-operatively by digital rectal examination (single examiner), Park's score and Corman's score in all cases and using barium hold and transperineal ultrasonography, manometric studies in a few cases. The outcome was measured at an average follow-up of 8.8 months (7–24 months). RESULTS: As per Park's score 26 patients had Grade I continence, two had Grade II and two patients had Grade III continence. Corman's score improved from fair to excellent in 26 patients. The patients in whom manometry was performed showed a remarkable rise in both resting and squeeze pressures. Two patients developed post-operative infections in upper 1/3 thigh incision site and three patients at gluteal region scar site. CONCLUSION: Satisfactory continence following gracilis muscle could be achieved. Medknow Publications & Media Pvt Ltd 2016 /pmc/articles/PMC4878240/ /pubmed/27274119 http://dx.doi.org/10.4103/0970-0358.182236 Text en Copyright: © Indian Journal of Plastic Surgery http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution NonCommercial ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Kulkarni, Jiten Patil, Anuradha J. Musande, Bhaskar Bhamare, Abhishek B. Management of fourth degree obstetric perineal tear without colostomy using non - stimulated gracilis - our experience over eleven years |
title | Management of fourth degree obstetric perineal tear without colostomy using non - stimulated gracilis - our experience over eleven years |
title_full | Management of fourth degree obstetric perineal tear without colostomy using non - stimulated gracilis - our experience over eleven years |
title_fullStr | Management of fourth degree obstetric perineal tear without colostomy using non - stimulated gracilis - our experience over eleven years |
title_full_unstemmed | Management of fourth degree obstetric perineal tear without colostomy using non - stimulated gracilis - our experience over eleven years |
title_short | Management of fourth degree obstetric perineal tear without colostomy using non - stimulated gracilis - our experience over eleven years |
title_sort | management of fourth degree obstetric perineal tear without colostomy using non - stimulated gracilis - our experience over eleven years |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4878240/ https://www.ncbi.nlm.nih.gov/pubmed/27274119 http://dx.doi.org/10.4103/0970-0358.182236 |
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