By Raffaele De Caro, Andrea Porzionato, Veronica Macchi (auth.), Donato F. Altomare, Filippo Pucciani (eds.)
The pathophysiology of exterior rectal prolapse continues to be doubtful, and its scientific and instrumental diagnostic evaluation in addition to the precise surgical or scientific method must be clarified. The relative rarity of this pathology prevents randomised, managed trials from being performed in one establishment and the critiques of remarkable leaders during this box are accordingly really vital. With this collaborative, multiauthor paintings, the editors fulfil that requirement through drawing jointly the adventure of hugely regarded nationwide and foreign pros. the quantity comprises wide and helpful information about most well liked equipment of comparing sufferers with rectal prolapse: its underlying aetiology and pathophysiology, the several remedy tools (both surgical and nonsurgical), the anticipated useful effects following surgical procedure and the administration of complicated medical displays linked to this situation. The textual content is augmented with unparalleled illustrations, together with either fine quality, operative color photos and line drawings, which show sincerely the correct phases of the method being mentioned. This quantity is a different ebook that covers all facets of the and should be a helpful source for surgeons, gastroenterologists, radiologists and different practitioners eager about the administration of this disorder.
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Extra resources for Rectal Prolapse: Diagnosis and Clinical Management
Piloni, A. Bazzocchi, R. Golfieri sonography, the pubococcygeal line can easily be traced, allowing comparable measurement of pelvic organ descent by imaging techniques. e. evacuation proctography combined with opacification of the pelvic viscera [3–7], is considered the imaging technique of choice for investigating pelvic floor prolapse affecting the bladder (cystocele), vagina (vaginal vault prolapse), small bowel (enterocele) and rectum (rectocele). Preparation for the fluoroscopic examination requires that, at the arrival of the patient at the X-ray department, a standard dose of 120 ml of liquid barium suspension (Pronto Bario HD 68% wt/vol, Bracco, Milan, Italy) is given orally to opacify the small-bowel loops, which usually are visualised in the lower pelvis 2–3 h later.
Apart from the alterations registered in patients with prolapsing haemorrhoids (higher threshold levels), in neurogenic incontinence, a wide spectrum of findings can be observed, probably related to the degree of pudendal neuropathy. Also, rectal sensation measurements by electrophysiological study are meaningful. In patients suffering from constipation, threshold levels are frequently higher than normal, even if this is not the rule. In incontinent patients with only sphincter lesion(s), mucosal electrosensitivity could be normal.
10. 11. 12. 13. 14. 15. 16. 17. 18. 19. tion proctography (defecography): an aid to the investigation of pelvic floor disorders. Obstet Gynecol 83:307–314 Hock D, Lombard R, Jehaes C et al (1993) Colpocystodefecography. Dis Colon Rectum 36:1015–1021 Kelvin FM, Maglinte DDT, Benson JT et al (1994) Dynamic cystoproctography: a technique for assessing disorders of the pelvic floor in women. AJR Am J Roentgenol 163:368–370 Maglinte DDT, Kelvin FM, Hale DS et l (1997) Dynamic cystoproctography: a unifying diagnostic approach to pelvic floor and anorectal dysfunction.
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