دورية أكاديمية
Descending perineal syndrome cure by deep transversus perinei ligament repair: surgical options.
| العنوان: | Descending perineal syndrome cure by deep transversus perinei ligament repair: surgical options. |
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| المؤلفون: | Hodgson R; Department of Obstetrics and Gynaecology, University of NSW Port Macquarie Campus, Port Macquarie, Australia., Wagenlehner F; Clinic of Urology, Pediatric Urology and Andrology, Justus Liebig University Giessen, Giessen, Germany., Del Amo E; Hospital del Mar, Passeig Marítim, Barcelona, Spain., Inoue H; Urogynecology Center, Shonan Kamakura General Hospital, Kamakura, Japan., Abendstein B; Department of Obstetrics and Gynaecology, Landeskrankenhaus Feldkirch, Academic Teaching Hospital, Feldkirch, Austria. |
| المصدر: | Annals of translational medicine [Ann Transl Med] 2024 Apr 22; Vol. 12 (2), pp. 32. Date of Electronic Publication: 2024 Apr 18. |
| نوع المنشور: | Journal Article; Review |
| اللغة: | English |
| بيانات الدورية: | Publisher: AME Publishing Company Country of Publication: China NLM ID: 101617978 Publication Model: Print-Electronic Cited Medium: Print ISSN: 2305-5839 (Print) Linking ISSN: 23055839 NLM ISO Abbreviation: Ann Transl Med Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Original Publication: [Hong Kong] : AME Publishing Company |
| مستخلص: | Descending perineal syndrome (DPS) was described by Parks et al. as descent of the anus on straining, typically 3-4 cm below a line drawn from the coccyx to the lower end of the. DPS is associated with obstructed defecation, with increased bulging of the perineum with straining, although perineal descent can also be seen at rest. In their review, Chaudhry and Tarnay stated: " It is controversial whether surgical management is even an option for patients with DPS ". The deep transversus perinei (DTP) ligaments are the suspensory ligaments of the perineal body (PB). DTP are approximately 4 cm long. They attach behind the upper 2/3 and lower 1/3 of the descending ramus. If, at childbirth, the PB is overstretched and displaced laterally and inferiorly, the DTP lengthens. DPS is described as descent of the anus on straining, typically 3-4 cm below a line drawn from the coccyx to the lower end of the symphysis. DPS is associated with obstructed and often, assisted defecation, with increased bulging of the perineum with straining descent of the anus on straining. The surgical methodology begins as a standard PB repair which dissects the rectum from the vagina and PB and approximates the displaced components of the PB. We added an additional step: identifying the DTPs, shortening and reinforcing them with the Tissue Fixation System (TFS) minisling or No. 2 polyester sutures. High cure rates for obstructed defecation were achieved with the TFS minisling, and initial results using No. 2 polyester sutures are favourable. The key messages from both operations is DPS is caused by stretching and elongation of DPS ligaments, and these are surgically repairable. Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://atm.amegroups.com/article/view/10.21037/atm-23-1803/coif). The series “Integral Theory Paradigm” was commissioned by the International Society for Pelviperineology without any funding or sponsorship. The authors have no other conflicts of interest to declare. (2024 Annals of Translational Medicine. All rights reserved.) |
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| فهرسة مساهمة: | Keywords: Deep transversus perinei ligaments (DTP ligaments); descending perinei syndrome; perineal body sling (PB sling); wide-bore polyester sutures |
| تواريخ الأحداث: | Date Created: 20240509 Latest Revision: 20240510 |
| رمز التحديث: | 20240510 |
| مُعرف محوري في PubMed: | PMC11075953 |
| DOI: | 10.21037/atm-23-1803 |
| PMID: | 38721449 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 2305-5839 |
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| DOI: | 10.21037/atm-23-1803 |