Benign proctology
- Three-Dimensional Pelvic Floor Ultrasound Assessment of Pelvic Organ Prolapse: Minimal Levator Hiatus and Levator Ani Deficiency Score
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Yongwoo Yune, Hong Yoon Jeong, Duk Hoon Park, Jong Kyun Lee
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Ann Coloproctol. 2021;37(5):291-297. Published online August 9, 2021
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DOI: https://doi.org/10.3393/ac.2020.01095.0156
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4,476
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 Abstract
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- Purpose
The purpose of this study was to determine whether levator ani deficiency (LAD) scores and minimal levator hiatus (MLH) areas affect Pelvic Organ Prolapse Quantification (POP-Q) stage.
Methods
This study was a retrospective chart review of patients with pelvic organ prolapse (POP) at Seoul Songdo Hospital between August 2019 and August 2020. Three-dimensional (3D) pelvic floor ultrasound, preoperative anal manometry, and other physiological tests were performed in 78 patients with POP symptoms. We divided the patients into mild prolapse and severe prolapse groups based on the POP-Q. We examined the LAD and MLH areas. LAD scores were categorized as mild, moderate, or severe.
Results
There were 32 patients (41.0%) in the mild prolapse group (POP-Q stage I and II) and 46 (59.0%) in the severe prolapse group (POP-Q stage III and IV). The mean LAD score was significantly higher in severe prolapse group (13.33±2.49 vs. 8.19±2.92, P<0.001), and the rate of severe deficiency was also significantly higher in the severe prolapse group (29 [63.0%] vs. 2 [6.3%], P<0.001). The mean MLH was also significantly larger in the severe prolapse group (17.91±2.74 cm2 vs. 14.95±2.60 cm2, P<0.001). In addition, both MLH and LAD scores tended to increase at each stage.
Conclusion
There is a strong positive correlation between the POP-Q stage and the MLH and LAD scores that can be seen on 3D pelvic floor ultrasound. The findings of this study, by objectively demonstrating LAD and MLH in women with POP, are an important contribution to POP.
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Citations
Citations to this article as recorded by  - Pelvic floor dysfunction in patients with gestational diabetes mellitus
Mustafa Arslan, Ramazan Kozan
World Journal of Diabetes.2025;[Epub] CrossRef - The predicting value of the ratio of levator hiatus diameter to fetal head circumference in pregnant women at 37 weeks of gestation in the progression of the second stage of labor and levator ani injury 6 weeks postpartum
Bei Gan, Shan Zheng, Xiuyan Wu, Xuemei Li
Heliyon.2024; 10(4): e25636. CrossRef - Advancements in artificial intelligence for pelvic floor ultrasound analysis
Xinghua Huang
American Journal of Translational Research.2024; 16(4): 1037. CrossRef - Three‐dimensional endovaginal ultrasound assessment using the levator ani deficiency score in primiparas: A replication study
Emilia Rotstein, Vilhelmina Ullemar, Marianne Starck, Gunilla Tegerstedt
Acta Obstetricia et Gynecologica Scandinavica.2023; 102(9): 1236. CrossRef - Correlation between clinical examination and perineal ultrasound in women treated for pelvic organ prolapse
Célia Maheut, Thibaud Vernet, Hugo Le Boité, Hervé Fernandez, Perrine Capmas
Journal of Gynecology Obstetrics and Human Reproduction.2023; 52(9): 102650. CrossRef - Colonic pseudo-obstruction in a patient with dyssynergic defecation: A case report
Yejun Jeong, Yongjae Kim, Wonhyun Kim, Seoyeon Park, Su-Jin Shin, Eun Jung Park
International Journal of Surgery Case Reports.2022; 98: 107524. CrossRef - Is It a Refractory Disease?- Fecal Incontinence; beyond
Medication
Chungyeop Lee, Jong Lyul Lee
The Ewha Medical Journal.2022;[Epub] CrossRef
Benign proctology
- Prospective Comparative Analysis of the Incidence of Vasovagal Reaction and the Effect of Rectal Submucosal Lidocaine Injection in Stapled Hemorrhoidopexy: A Randomized Controlled Trial
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Kyung Jin Cho, Do Yeon Hwang, Hyun Joo Lee, Ki Hoon Hyun, Tae Jung Kim, Duk Hoon Park
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Ann Coloproctol. 2020;36(5):344-348. Published online March 16, 2020
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DOI: https://doi.org/10.3393/ac.2020.02.12
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4,537
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155
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2
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Abstract
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- Purpose
This study was performed to evaluate the incidence of vasovagal reactions (VVRs) and the efficacy of lidocaine injection for prevention.
Methods
One hundred seventeen patients diagnosed with hemorrhoids and scheduled to undergo a stapled hemorrhoidopexy (SH) were randomly divided according to submucosal injection to the rectum: lidocaine group (n = 53, lidocaine injected just before full closure of the stapler) and control group (n = 58). Outcomes included baseline patient characteristics (American Society of Anesthesiologists physical status classification, body mass index, diabetes mellitus, hypertension, and previous VVR history), vital signs during the operation, incidence of VVRs (hypotension, bradycardia, dizziness, diaphoresis, and nausea/vomiting), and postoperative complications (pain, bleeding, and urinary retention).
Results
Baseline characteristics were similar between groups. The number of patients with lower abdominal pain after firing the stapler and incidence of dizziness were lower for the lidocaine group than for the control group (9.4% vs. 25.9%, P = 0.017; 0% vs. 8.6%, P = 0.035, respectively). However, there were no significant between-group differences in incidence of nausea and diaphoresis (0% vs. 3.4%, P = 0.172) and syncope (1.9% vs. 3.4%, P = 0.612). Fewer patients in the lidocaine group complained of postoperative pain (41.5% vs. 58.6%, P = 0.072), and these patients used analgesics less frequently than those in the control group (28.3% vs. 36.2%, P = 0.374).
Conclusion
Patients who received a submucosal lidocaine injection prior to SH experienced less lower abdominal pain and dizziness compared with those who received standard treatment. A larger, more detailed prospective study is needed for further analysis.
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Citations
Citations to this article as recorded by - Reducing Pain, Spasm, and Vasovagal Syndrome in Transradial Cardiac Angiography: The Role of Lidocaine Cream and Injectable Lidocaine
Behrang Bahreini, Saeed Alipour Parsa, Vahid Eslami, Mohammad Khani, Abdolhamid Bagheri
International Journal of Cardiovascular Practice.2024;[Epub] CrossRef - PROSPECT guideline for haemorrhoid surgery
Alexis Bikfalvi, Charlotte Faes, Stephan M. Freys, Girish P. Joshi, Marc Van de Velde, Eric Albrecht
European Journal of Anaesthesiology Intensive Care.2023; 2(3): e0023. CrossRef - Treatment of Hemorrhoid in Unusual
Condition-Pregnancy
Hyo Seon Ryu
The Ewha Medical Journal.2022;[Epub] CrossRef - The Effort to Reduce Vasovagal Reaction and Abdominal Pain During Stapled Hemorrhoidopexy
Hyeonseok Jeong
Annals of Coloproctology.2020; 36(5): 291. CrossRef
Benign proctology
- Comparison of 3-Dimensional Pelvic Floor Ultrasonography and Defecography for Assessment of Posterior Pelvic Floor Disorders
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Hong Yoon Jeong, Shi-Jun Yang, Dong Ho Cho, Duk Hoon Park, Jong Kyun Lee
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Ann Coloproctol. 2020;36(4):256-263. Published online March 16, 2020
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DOI: https://doi.org/10.3393/ac.2020.02.09
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4,136
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124
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6
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7
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Abstract
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- Purpose
The aim of this study was to determine the accuracy of 3-dimensional (3D) pelvic floor ultrasonography and compare it with defecography in assessment of posterior pelvic disorders.
Methods
Eligible patients were consecutive women undergoing 3D pelvic floor ultrasonography at one hospital between August 2017 and February 2019. All 3D pelvic floor ultrasonography was performed by one examiner. A total of 167 patients with suspected posterior pelvic disorder was retrospectively enrolled in the study. The patients were divided into 3 groups according to the main symptoms.
Results
There were 82 rectoceles on defecography (55 barium trapping) and 84 on 3D pelvic floor ultrasonography. Each modality identified 6 enteroceles. There were 43 patients with pelvic floor dyssynergia on defecography and 41 on ultrasonography. There were 84 patients with intussusception on defecography and 41 on 3D pelvic floor ultrasonography. Agreement of the 2 diagnostic tests was confirmed using Cohen’s kappa value. Rectocele (kappa, 0.784) and enterocele (kappa, 0.654) both indicated good agreement between defecography and 3D pelvic floor ultrasonography. In addition, pelvic floor dyssynergia (kappa, 0.406) showed moderate agreement, while internal intussusception (kappa, 0.296) had fair agreement.
Conclusion
This study showed good agreement for detection of posterior pelvic disorders between defecography and 3D pelvic floor ultrasonography.
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Citations
Citations to this article as recorded by - Can we use integrated total pelvic floor ultrasound as a screening tool in defaecatory pelvic floor dysfunction? A prospective evaluation of the accuracy of integrated total pelvic floor ultrasound compared with defaecation proctography
Charlotte Ralston, Max Reena, Deepa Solanki, Samantha Morris, Alexis M. P. Schizas, Andrew B. Williams, Alison J. Hainsworth
Colorectal Disease.2025;[Epub] CrossRef - Clinical value of transperineal ultrasound in evaluating the diagnostic grade of rectocele in Chinese women with obstructed defecation syndrome: An observational study
Yunlin Jiang, Zhimin Fan, Ling Gao, Guangshu Shen, Jingjing Yue, Xiaofeng Wang, Xueping Zheng, Yahong Xue
Medicine.2024; 103(36): e39259. CrossRef - Rectal prolapse and surgery for faecal incontinence
Judith Johnston, Athur Harikrishnan
Surgery (Oxford).2023; 41(7): 449. CrossRef - Role of contrast-enhanced ultrasonography in MR-guided focused ultrasound ablation on uterus fibroids: lesion selection and assessment of ablative effects
Wen Luo, Pei-di Zhang, Xiao Yang, Jian-min Zheng, Ying Liu, Xing Tang, Hai-jing Liu, Lei Ding, Li-na Pang, Xiao-dong Zhou, Li-wen Liu, Min-wen Zheng
European Radiology.2022; 32(3): 2110. CrossRef - Colonic pseudo-obstruction in a patient with dyssynergic defecation: A case report
Yejun Jeong, Yongjae Kim, Wonhyun Kim, Seoyeon Park, Su-Jin Shin, Eun Jung Park
International Journal of Surgery Case Reports.2022; 98: 107524. CrossRef - Is It a Refractory Disease?- Fecal Incontinence; beyond
Medication
Chungyeop Lee, Jong Lyul Lee
The Ewha Medical Journal.2022;[Epub] CrossRef - Three-Dimensional Pelvic Floor Ultrasound Assessment of Pelvic Organ Prolapse: Minimal Levator Hiatus and Levator Ani Deficiency Score
Yongwoo Yune, Hong Yoon Jeong, Duk Hoon Park, Jong Kyun Lee
Annals of Coloproctology.2021; 37(5): 291. CrossRef
- Clinical Study and Review of Articles (Korean) about Retrorectal Developmental Cysts in Adults
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Sung Wook Baek, Haeng Ji Kang, Ji Yong Yoon, Do Youn Whang, Duk Hoon Park, Seo Gue Yoon, Hyun Sik Kim, Jong Kyun Lee, Jung Dal Lee, Kwang Yun Kim
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J Korean Soc Coloproctol. 2011;27(6):303-314. Published online December 31, 2011
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DOI: https://doi.org/10.3393/jksc.2011.27.6.303
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6,675
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55
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21
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Abstract
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- Purpose
A retrorectal developmental cyst (tailgut cyst, epidermoid cyst, dermoid cyst, teratoma, and duplication) is very rare disease, and the symptoms are not characteristic so that sometimes this disease is still misdiagnosed as a supralevator abscess or a complex anal fistula. We would like to present a clinical approach to this disease. MethodsWe retrospectively examined the charts of 15 patients who were treated for retrorectal cysts from January 2001 to November 2009. ResultsAll 15 patients were female. The average age was 41 years (range, 21 to 60 years). Fourteen patients (93.3%) were symptomatic, and the most common symptom was anal pain or discomfort. Nine patients (60%) had more than one previous operation (range, 1 to 9 times) for a supralevator abscess, an anal fistula, etc. In 12 patients (80%), the diagnosis could be made by using the medical history and physical examination. Thirteen cysts (80%) were excised completely through the posterior approach. The average diameter of the cysts was 4.8 cm (range, 2 to 10 cm). Pathologic diagnoses were 8 tailgut cysts (53.3%), 5 epidermoid cysts (33.3%) and 2 dermoid cysts (13.3%). The average follow-up period was 18.3 months (range, 1 to 64 months). ConclusionIn our experience, high suspicion and physical examination are the most important diagnostic methods. If a female patient has a history of multiple perianal operations, a retrorectal bulging soft mass, a posterior anal dimple, and no conventional creamy foul odorous pus in drainage, the possibility of a retrorectal developmental cyst must be considered.
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Citations
Citations to this article as recorded by - Pararectal Epidermal Inclusion Cyst in a Pediatric Patient
Nour H Moosa, Hadeel Bozieh, Nermin Darawi, Fatima Hajjaj, Noor Awad, Firas Almasaid
Cureus.2024;[Epub] CrossRef - Endoscopic Resection of Tailgut Cyst
Oleksandr Kiosov, Vladyslav Tkachov, Sergii Gulevskyi, Yoshifumi Nakayama
Case Reports in Gastrointestinal Medicine.2024;[Epub] CrossRef - Presacral Keratinous and Dermoid Cyst Masquerading as Meningocele – A Rare Case Report
Lucky Gupta
African Journal of Paediatric Surgery.2024; 21(4): 271. CrossRef - A report of presacral epidermoid cyst in perimenopausal women: An extremely rare site and an unusual cause of chronic constipation
Salem M. Tos, Afnan W.M. Jobran, Anas Alasafrah, Izzeddin Bakri, Fahmi Jubran
International Journal of Surgery Case Reports.2023; 103: 107880. CrossRef - Retrorectal epidermoid mistaken for perirectal swelling: A case report
Mossaab Ghannouchi, Mohamed Ben Khalifa, Olfa Zoukar, Karim Nacef, Amina Chakka, Moez Boudokhan
International Journal of Surgery Case Reports.2022; 95: 107187. CrossRef - Perirectal epidermoid cyst in a patient with sacrococcygeal scoliosis and anal sinus: A case report
Zhou-Xin Ji, Song Yan, Xu-Can Gao, Li-Fen Lin, Qiang Li, Qi Yao, Dong Wang
World Journal of Clinical Cases.2022; 10(30): 11139. CrossRef - Chinese expert consensus on standardized treatment for presacral cysts
Gangcheng Wang, Chengli Miao
Gastroenterology Report.2022;[Epub] CrossRef - Presacral epidermoid cyst in a pediatric patient
Lilly Gu, Cara L. Berkowitz, John D. Stratigis, Lee K. Collins, Maria Mostyka, Nitsana A. Spigland
Journal of Pediatric Surgery Case Reports.2021; 71: 101904. CrossRef - Epidemiology, diagnostic approach and therapeutic management of tailgut cysts: A systematic review
Aikaterini Mastoraki, Ilias Giannakodimos, Karmia Panagiotou, Maximos Frountzas, Dimosthenis Chrysikos, Stylianos Kykalos, Georgios E. Theodoropoulos, Dimitrios Schizas
International Journal of Clinical Practice.2021;[Epub] CrossRef - Successful excision of a retrorectal cyst through trans-sacral approach: A case report
Tlal Matouq Alsofyani, Mohammed Yousef Aldossary, Faisal Fahd AlQahtani, Khalid Sabr, Ameera Balhareth
International Journal of Surgery Case Reports.2020; 71: 307. CrossRef - Anal Gland/Duct Cyst: A Case Report
Guh Jung Seo, Ju Heon Seo, Kyung Jin Cho, Hyung-Suk Cho
Annals of Coloproctology.2020; 36(3): 204. CrossRef - Retrorectal Epidermal Inclusion Cyst: An Incidental Finding During Cesarean Section
Sundus Nasim, Sohail Kumar, Dua Azim, Lajpat Rai, Summaya Saeed
Cureus.2020;[Epub] CrossRef - Combined laparoscopic and perineal approach for the management of recurrent tailgut cyst
Ankur Patel, Pranav Mandovra, Tanveer Majeed, Roy V Patankar
Asian Journal of Endoscopic Surgery.2019; 12(2): 181. CrossRef - Laparoscopic management of epidermoid cyst in an unusual location
Sindhuja Kesavan, Ramakrishnan Parthasarathi, Prakhar Gupta, Chinnusamy Palanivelu
BMJ Case Reports.2019; 12(2): e228043. CrossRef - Tailgut cyst: report of three cases and review of the literature
Ann-Sophie Hufkens, Peter Cools, Paul Leyman
Acta Chirurgica Belgica.2019; 119(2): 110. CrossRef - Malignant transformation of tailgut cysts is significantly higher than previously reported: systematic review of cases in the literature
K. Nicoll, C. Bartrop, S. Walsh, R. Foster, G. Duncan, C. Payne, C. Carden
Colorectal Disease.2019; 21(8): 869. CrossRef - Laparoscopic surgical management of a mature presacral teratoma: a case report
Liming Wang, Yasumitsu Hirano, Toshimasa Ishii, Hiroka Kondo, Kiyoka Hara, Shintaro Ishikawa, Takuhisa Okada, Nao Obara, Shigeki Yamaguchi
Surgical Case Reports.2019;[Epub] CrossRef - Pre-sacral (retrorectal) abnormal tissue and tumours may be described by a new classification – A review article
Mohammad Bukhetan Alharbi
International Journal of Surgery Open.2018; 11: 1. CrossRef - Precoccygeal epidermoid cyst in a child — A unique case report
J.S. Aihole, G. Aruna, J. Deepak, S. Supriya
African Journal of Urology.2018; 24(4): 336. CrossRef - A Complicated Case of Pregnancy Involving a Presacral Epidermoid Cyst
Daisuke Shigemi, Seiryu Kamoi, Akihisa Matsuda, Toshiyuki Takeshita
Journal of Nippon Medical School.2017; 84(2): 100. CrossRef - Presacral Noncommunicating Enteric Duplication Cyst
Shabnam Seydafkan, David Shibata, Julian Sanchez, Nam D. Tran, Marino Leon, Domenico Coppola
Cancer Control.2016; 23(2): 170. CrossRef
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