Benign bowel disease
- Anal canal coronal-sagittal ratio: a novel parameter for diagnosing pelvic floor injury in 2-dimensional transanal ultrasound
-
Hong Yoon Jeong, Keehoon Hyun, Jong Kyun Lee
-
Ann Coloproctol. 2024;40(5):459-466. Published online November 10, 2022
-
DOI: https://doi.org/10.3393/ac.2022.00129.0018
-
-
Abstract
PDF
- Purpose
Pelvic floor injury diagnosis using 3-dimensional (3D) pelvic floor ultrasound or magnetic resonance imaging is unfeasible in many clinics. We assessed the efficacy of a novel diagnostic parameter, the anal canal coronal-sagittal (CS) ratio, for pelvic floor injury on 2D transanal ultrasound.
Methods This retrospective study analyzed the data of 126 female patients who underwent 3D pelvic floor ultrasound (including 2D transanal ultrasound) at a pelvic floor center between August and December 2020. The anal canal CS ratio on 2D transanal ultrasound and pelvic floor avulsion injury measurements were recorded for all patients.
Results A cutoff anal canal CS ratio of 1.15 was obtained using receiver operating characteristic analysis (sensitivity, 0.820; specificity, 0.763; and area under the curve, 0.838). Patients were categorized into the anal canal CS ratio ≥1.15 and the anal canal CS ratio <1.15 groups. Bilateral pelvic floor avulsion was more common in the anal canal CS ratio ≥1.15 group (n=35, 56.5%), and the incidence of pelvic floor avulsion was significantly different between the 2 groups (P=0.001). Existing parameters of pelvic floor injury, including minimal levator hiatus (P=0.001), levator plate descent angle (P=0.001), and levator ani deficiency score (P=0.001), were statistically different between the 2 groups.
Conclusion The anal canal CS ratio was an efficient novel parameter that indirectly detected pelvic floor injury in 2D transanal ultrasound. It is a potential alternative indicator for pelvic floor injury on the widely popular 2D transanal ultrasound.
Benign proctology,Postoperative outcome & ERAS,Complication
- Predictors of postoperative urinary retention after semiclosed hemorrhoidectomy
-
Hong Yoon Jeong, Seok Gyu Song, Jong Kyun Lee
-
Ann Coloproctol. 2022;38(1):53-59. Published online July 21, 2021
-
DOI: https://doi.org/10.3393/ac.2021.00304.0043
-
-
8,697
View
-
171
Download
-
8
Web of Science
-
10
Citations
-
Abstract
PDF
- Purpose
This study was performed to analyze the predictors that might contribute to urinary retention following semiclosed hemorrhoidectomy under spinal anesthesia.
Methods This retrospective study enrolled 2,176 consecutive patients with symptomatic grade III to IV hemorrhoids who underwent semiclosed hemorrhoidectomy between September 2018 and September 2019.
Results Among the 2,176 patients, 1,878 (86.3%) had no postoperative urinary retention, whereas 298 (13.7%) developed urinary retention after hemorrhoidectomy. The percentage of males was significantly higher in the retention group than in the non-retention group (60.4% vs. 48.1%; P=0.001). The risk of urinary retention was 1.52-fold higher in males than in females (95% confidence interval [CI], 1.13–2.04; P=0.005), 1.62-fold higher in old age (95% CI, 1.14–2.28; P=0.006), and 1.37-fold higher with high body mass index (BMI) (95% CI, 1.04–1.81; P=0.025). Patients with ≥4 resected hemorrhoids had a higher odds ratio (OR) of 1.46 (95% CI, 1.12–1.89; P=0.005) than patients with <4 resected hemorrhoids. Among the supplementary medication, patients who used analgesics had a higher OR of 2.06 (95% CI, 1.57–2.68; P=0.001) than those who did not.
Conclusion Male sex, age, high BMI, number of resected hemorrhoids, and supplementary analgesics are independent risk factors for urinary retention after semiclosed hemorrhoidectomy.
-
Citations
Citations to this article as recorded by 
- Assessment of the efficacy and safety of pudendal nerve block in post-hemorrhoidectomy pain: A meta-analysis of randomized controlled trials
Jun Li, Hai-Qiong Wu, Jun-Tao Zhang, Shi-Jian Liu, Ke-Lin Peng Asian Journal of Surgery.2025;[Epub] CrossRef - Comparison of the effect of hot and cold compresses on post‐operative urinary retention in older patients: A clinical trial study
Tayebeh Mirzaei, Farkhondeh Roudbari, Ali Ravari, Sakineh Mirzaei, Elham Hassanshahi International Journal of Urological Nursing.2024;[Epub] CrossRef - General anesthesia with local infiltration reduces urine retention rate and prolongs analgesic effect than spinal anesthesia for hemorrhoidectomy
Chun-Yu Lin, Yi-Chun Liu, Jun-Peng Chen, Pei-Hsuan Hsu, Szu-Ling Chang Frontiers in Surgery.2024;[Epub] CrossRef - Effective non-surgical treatment of hemorrhoids with sclerosing foam and novel injection device
Juan Cabrera Garrido, Gonzalo López González Gastroenterology & Endoscopy.2024; 2(4): 176. CrossRef - Effect of incision location and type of fistula on postoperative urinary retention after radical surgery for anal fistula: a retrospective analysis
Chen Li, Ningyuan Liu, Zichen Huang, Zijian Wei, Keyi Li, Wenxiao Hou, Sangyu Ye, Lihua Zheng BMC Gastroenterology.2024;[Epub] CrossRef - Ten-year multicentric retrospective analysis regarding postoperative complications and impact of comorbidities in hemorrhoidal surgery with literature review
Cosmin Moldovan, Elena Rusu, Daniel Cochior, Madalina Elena Toba, Horia Mocanu, Razvan Adam, Mirela Rimbu, Adrian Ghenea, Florin Savulescu, Daniela Godoroja, Florin Botea World Journal of Clinical Cases.2023; 11(2): 366. CrossRef - Effect of single spinal anesthesia with two doses ropivacaine on urinary retention after hemorrhoidectomy in male patients
Lei-lei Wang, Meng Kang, Li-xin Duan, Xu-fei Chang, Xiao-xin Li, Xiang-yang Guo, Zhi-yu Kang, Yong-zheng Han Frontiers in Surgery.2023;[Epub] CrossRef - Efficacy of Low-Frequency Electroacupuncture on Urinary Retention After Spinal Anesthesia
Mina Olia, Aliakbar Jafarian, Masood Mohseni Journal of PeriAnesthesia Nursing.2023; 38(5): 745. CrossRef - Laser hemorrhoidoplasty combined with blind hemorrhoidal artery ligation compared to Milligan–Morgan hemorrhoidectomy in patients with second and third degree piles; a prospective randomized study
Amir F. Abdelhamid, Mohamed M. Elsheikh, Osama H. Abdraboh The Egyptian Journal of Surgery.2023; 42(3): 669. CrossRef - Tarlov cyst with self-healing cauda equina syndrome following combined spinal-epidural anesthesia: a case report
Zhexuan Chen, Chuxi Lin BMC Anesthesiology.2023;[Epub] CrossRef
Benign proctology
- 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
-
Ann Coloproctol. 2021;37(5):291-297. Published online August 9, 2021
-
DOI: https://doi.org/10.3393/ac.2020.01095.0156
-
-
4,065
View
-
72
Download
-
6
Web of Science
-
7
Citations
-
Abstract
PDF
- 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.
-
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
- Puborectalis Muscle Involvement on Magnetic Resonance Imaging in Complex Fistula: A New Perspective on Diagnosis and Treatment
-
Hong Yoon Jeong, Seok Gyu Song, Woo Jung Nam, Jong Kyun Lee
-
Ann Coloproctol. 2021;37(1):51-57. Published online September 18, 2020
-
DOI: https://doi.org/10.3393/ac.2020.08.26.1
-
-
3,677
View
-
111
Download
-
5
Web of Science
-
5
Citations
-
Abstract
PDF
- Purpose
According to recent studies, magnetic resonance imaging (MRI) assessment of complex fistulas provides a significant benefit compared to fistulography, computed tomography, and ultrasonography. The aim of this study was to describe the accuracy of MRI and the importance of identifying puborectalis muscle involvement on MRI in patients with complex fistula.
Methods All patients who were clinically diagnosed with ‘complex’ or showed multiple fistula tracts underwent fistula MRI. Eligible patients were consecutive patients who underwent fistula MRI between September 2018 and September 2019 at our hospital.
Results A total of 83 patients (74 males, 9 females; 116 tracts) were included in this study. The sensitivity and specificity of MRI in diagnosing fistula tracts were 94.8% and 98.2%, respectively. The sensitivity and specificity in identifying internal opening were 93.9% and 97.3%, respectively. Of the 35 patients with puborectalis muscle involvement in the MRI, 31 images of suprasphincteric-type patients on the Park’s classification were classified. The patients of puborectalis involvement were divided into 2 groups according to the surgical procedure that was performed. There were 12 sphincter-saving procedures and 19 sphincter division procedures performed. Recurrence was seen in 2 patients in the sphincter-saving procedure group, while no case was seen in the sphincter division procedure group. Five complications were found in the sphincter division procedure group, of which 2 reported incontinence.
Conclusion Fistula MRI is a highly accurate examination for evaluating complex fistulas, and the puborectalis muscle involvement findings are very important for diagnosis and treatment.
-
Citations
Citations to this article as recorded by 
- Efficacy and safety of transanal opening of intersphincteric space in the treatment of high complex anal fistula: A meta‑analysis
Chunqiang Wang, Tianye Huang, Xuebing Wang Experimental and Therapeutic Medicine.2024;[Epub] CrossRef - Comparison of loose combined cutting seton and traditional cutting seton for high anal fistula: a meta-analysis
Yi SUN, Chunqiang WANG, Tianye HUANG, Xuebing WANG Gazzetta Medica Italiana Archivio per le Scienze Mediche.2023;[Epub] CrossRef - Guidelines to diagnose and treat peri-levator high-5 anal fistulas: Supralevator, suprasphincteric, extrasphincteric, high outersphincteric, and high intrarectal fistulas
Pankaj Garg, Vipul D Yagnik, Sushil Dawka, Baljit Kaur, Geetha R Menon World Journal of Gastroenterology.2022; 28(16): 1608. CrossRef - What Does Puborectalis Muscle Involvement on Magnetic Resonance Imaging Indicate in Patients With Complex Anal Fistula?
Sung Uk Bae Annals of Coloproctology.2021; 37(1): 3. CrossRef - Anal fistula at roof of ischiorectal fossa inside levator-ani muscle (RIFIL): a new highly complex anal fistula diagnosed on MRI
Pankaj Garg, Sushil Dawka, Vipul D. Yagnik, Baljit Kaur, Geetha R. Menon Abdominal Radiology.2021; 46(12): 5550. CrossRef
Benign proctology
- Comparison of 3-Dimensional Pelvic Floor Ultrasonography and Defecography for Assessment of Posterior Pelvic Floor Disorders
-
Hong Yoon Jeong, Shi-Jun Yang, Dong Ho Cho, Duk Hoon Park, Jong Kyun Lee
-
Ann Coloproctol. 2020;36(4):256-263. Published online March 16, 2020
-
DOI: https://doi.org/10.3393/ac.2020.02.09
-
-
3,778
View
-
124
Download
-
5
Web of Science
-
6
Citations
-
Abstract
PDF
- 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.
-
Citations
Citations to this article as recorded by 
- 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
|