Download Practical Guide to Female Pelvic Medicine by Gamal M. Ghoniem, G. Willy Davila PDF

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By Gamal M. Ghoniem, G. Willy Davila

Pelvic flooring issues have an effect on a wide percentage of girls around the world. This publication is a hugely useful consultant highlighting all of the various varieties of such difficulties. incorporated are chapters at the pathophysiology of the feminine pelvic ground, the review and analysis of difficulties, the sensible administration of signs, and the issues which could come up from surgical and scientific remedy.

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1 Factors affecting fecal continence ● Stool volume and consistency ● Small bowel transit ● Colon transit ● Distensibility, tone, and capacity of the rectum ● Motility and evacuability of the rectum ● Anorectal angle ● Anorectal sensory and reflex mechanism ● Motility of the anal canal ● Anal canal high-pressure zone ● ● ● ● ● ● Continence: the ability to defer the urge to defecate until the time and place are convenient. Anal incontinence: any involuntary leakage of solid or liquid stool or gas.

Anal incontinence: any involuntary leakage of solid or liquid stool or gas. Fecal incontinence: leakage of liquid or solid stool. Passive incontinence: if the main problem of incontinence is due to loss of sensation in the anal canal, this is called passive incontinence. Quite often, there is also an internal anal sphincter defect and a low anal resting pressure. Fecal urgency: the sensation of urgency combined with the inability to defer defecation for more than 5 minutes. Urge fecal incontinence: withstanding the urge to defecate is impossible, resulting in incontinence episodes.

The frontal cortex is important for the awareness of the need to defecate. Common neurologic diseases affecting the central nervous system such as cerebrovascular accidents, multiple sclerosis, or dementia can all disturb sphincter function. If sphincter function is still intact and anal pressures are normal, reflex defecation will occur but voluntary inhibition is often impaired. 1,9,13 If lower motor neurons are damaged, there will be pelvic floor disturbances (see below). Very often, patients with neurogenic incontinence present with a complex neurologic lesion involving not just the motor but also the sensory pathway.

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