- Uncovering changes in proteomic signature of rat pelvic floor muscles in pregnancy. [Journal Article]
- AJAm J Obstet Gynecol 2019 Apr 29
- CONCLUSIONS: Pelvic floor muscles gain a distinct proteomic signature in pregnancy, which provides a mechanistic foundation for the antepartum physiological alterations acquired by these muscles. Variability in genes encoding these proteins may alter plasticity of the pelvic floor muscles and therefore the extent of the protective pregnancy-induced adaptations. Furthermore, pelvic floor muscles' proteome is divergent from that of the nonpelvic skeletal muscles.
- Keeping the pelvic floor healthy. [Journal Article]
- CClimacteric 2019; 22(3):257-262
- Female pelvic floor muscles form a diaphragm that spans the entire pelvic cavity. They consist of the fibers of the coccygeus and the levator ani muscles, the latter of which is composed of five part…
Female pelvic floor muscles form a diaphragm that spans the entire pelvic cavity. They consist of the fibers of the coccygeus and the levator ani muscles, the latter of which is composed of five parts. Together with their fascia, the pelvic floor muscles provide support for the urethra, the vagina, and the rectum and constrict the urethral, vaginal, and anal orifices. Alterations in the composition of the pelvic floor muscles at menopause appear to affect their properties and, thereby, their ability to function adequately. This can lead to an increased prevalence in urinary incontinence and other lower urinary tract dysfunction, pelvic organ prolapse, and genitourinary syndrome of menopause. This article aims to define the pelvic floor muscles and functions and to summarize the direct and indirect changes to women's pelvic floor muscles during and after menopause and through aging. A particular focus is also given to the evidence-based literature on how to keep pelvic floor muscles healthy during menopause and in postmenopause using conservative management therapy.
- A Review of the Surgical Management of Perineal Hernias in Dogs. [Review]
- JAJ Am Anim Hosp Assoc 2018 Jul/Aug; 54(4):179-187
- Perineal hernia refers to the failure of the muscular pelvic diaphragm to support the rectal wall, resulting in herniation of pelvic and, occasionally, abdominal viscera into the subcutaneous perinea…
Perineal hernia refers to the failure of the muscular pelvic diaphragm to support the rectal wall, resulting in herniation of pelvic and, occasionally, abdominal viscera into the subcutaneous perineal region. The proposed causes of pelvic diaphragm weakness include tenesmus associated with chronic prostatic disease or constipation, myopathy, rectal abnormalities, and gonadal hormonal imbalances. The most common presentation of perineal hernia in dogs is a unilateral or bilateral nonpainful swelling of the perineum. Clinical signs do occur, but not always. Clinical signs may include constipation, obstipation, dyschezia, tenesmus, rectal prolapse, stranguria, or anuria. The definitive diagnosis of perineal hernia is based on clinical signs and findings of weak pelvic diaphragm musculature during a digital rectal examination. In dogs, perineal hernias are mostly treated by surgical intervention. Appositional herniorrhaphy is sometimes difficult to perform as the levator ani and coccygeus muscles are atrophied and unsuitable for use. Internal obturator muscle transposition is the most commonly used technique. Additional techniques include superficial gluteal and semitendinosus muscle transposition, in addition to the use of synthetic implants and biomaterials. Pexy techniques may be used to prevent rectal prolapse and bladder and prostate gland displacement. Postoperative care involves analgesics, antibiotics, a low-residue diet, and stool softeners.
- A randomized double-blind placebo-controlled trial on the effect of local analgesia on postoperative gluteal pain in patients undergoing sacrospinous ligament colpopexy. [Randomized Controlled Trial]
- AJAm J Obstet Gynecol 2018; 218(6):599.e1-599.e8
- CONCLUSIONS: Intraoperative administration of local analgesia does not reduce patients' perceptions of postoperative gluteal pain after sacrospinous ligament colpopexy; however, it may reduce the need for pain medication after surgery.
- Pelvic muscles' mechanical response to strains in the absence and presence of pregnancy-induced adaptations in a rat model. [Journal Article]
- AJAm J Obstet Gynecol 2018; 218(5):512.e1-512.e9
- CONCLUSIONS: Delivery-related strains lead to acute sarcomere elongation, a well-established cause of mechanical injury in skeletal muscles. Sarcomere hyperelongation resultant from mechanical strains is attenuated by pregnancy-induced adaptations acquired by the pelvic floor muscles prior to parturition.
- Sonogram of coccygeus muscle in dairy cows with different gestational ages. [Journal Article]
- JAJ Anim Sci Technol 2017; 59:26
- CONCLUSIONS: The ultrasound image of coccygeus muscle was affected by gestational status, thus this method may be used as one of the new methods of indirect gestational detection on dairy cows.
- Cadaveric Nerve and Artery Proximity to Sacrospinous Ligament Fixation Sutures Placed by a Suture-Capturing Device. [Journal Article]
- OGObstet Gynecol 2017; 130(5):1033-1038
- CONCLUSIONS: The middle segment of the sacrospinous ligament has the lowest incidence of nerves and arteries associated with it. This study confirms that the nerves supplying the pelvic floor muscles are at a higher risk from entrapment than the pudendal nerve.
- Coccygodynia - pathogenesis, diagnostics and therapy. Review of the writing. [Review]
- PPPol Przegl Chir 2017 Aug 31; 89(4):33-40
- Coccygodynia is a problem with a small percentage (1%) of the population suffering from musculoskeletal disorders. This pain is often associated with trauma, falling on the tailbone, long cycling, or…
Coccygodynia is a problem with a small percentage (1%) of the population suffering from musculoskeletal disorders. This pain is often associated with trauma, falling on the tailbone, long cycling, or by women after childbirth. The reason for the described problem can be the actual morphological changes. Idiopathic coccygodynia causes therapeutic difficulties to specialists of many fields. Unsatisfactory treatment, including coccygectomy tends to seek new solutions. They belong to them techniques exploited in the manual therapy which in their spectrum hold: direct techniques - per rectum as well as indirect techniques taking into account distant structures of the motor organ, remaining in dense interactions with the coccygeal part. Idiopathic coccygodynia is a result perhaps from exaggerated tension the muscle of the levator ani, coccygeus and gluteus maximus as well as from irritating soft tissue structures surrounding the coccyx: of sacrococcygeum, sacrospinale, and sacrotuberale ligament. Unfortunately we can't see them in objective examinations so as: the RTG, MR or TK, therefore constitute the both diagnostic and therapeutic problem. For describing the problem a writing of the object was used both from the field of the surgery and of manual therapy. Detailed and multifaceted knowledge about causes of the described problem allows more accurately to categorize the patient to the appropriate group and helps to select the best procedure of treatment.
- Transvaginal Mesh Insertion in the Ovine Model. [Journal Article]
- JVJ Vis Exp 2017 07 27; (125)
- This protocol describes mesh insertion into the rectovaginal septum in sheep using a single vaginal incision technique, with and without the trocar-guided insertion of anchoring arms. Parous sheep un…
This protocol describes mesh insertion into the rectovaginal septum in sheep using a single vaginal incision technique, with and without the trocar-guided insertion of anchoring arms. Parous sheep underwent the dissection of the rectovaginal septum, followed by the insertion of an implant with or without four anchoring arms, both designed to fit the ovine anatomy. The anchoring arms were put in place using a trocar and an "outside-in" technique. The cranial arms were passed through the obturator, gracilis, and adductor magnus muscles. The caudal arms were fixed near the sacrotuberous ligament, through the coccygeus muscles. This technique allows for the mimicking of surgical procedures performed in women suffering from pelvic organ prolapse. The anatomical spaces and elements are easily identified. The most critical part of the procedure is the insertion of the cranial trocar, which can easily penetrate the peritoneal cavity or the surrounding pelvic organs. This can be avoided by a more extensive retroperitoneal dissection and by guiding the trocar more laterally. This approach is designed only for experimental testing of novel implants in large animal models, as trocar-guided insertion is currently not used clinically.
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- Architectural assessment of rhesus macaque pelvic floor muscles: comparison for use as a human model. [Journal Article]
- IUInt Urogynecol J 2017; 28(10):1527-1535
- CONCLUSIONS: Overall, RM provides the closest architectural representation of human PFM complex among species examined; however, differences between individual PFMs should be taken into consideration. As RM is closely followed by rat with respect to PFM similarity with humans, this less-sentient and substantially cheaper model is a good alternative for PFM studies.