INTRODUCTION High-grade anal intraepithelial neoplasia, also referred to as anal squamous carcinoma in-situ, or Bowen's disease of the anus, make up less than 1% of all digestive system cancers in the United States. The treatment of choice is surgical resection with anal mapping. However, this disease often recurs or persists, requiring additional surgery for these patients. This can compromise...

1 on the anatomy of the levator ani, and especially the puborectalis muscle by use of MRI and CT. The authors state that the levator ani has a transverse portion and a vertical portion and that the puborectalis muscle is a u-shaped muscle outside the vertical portion. Based on those findings, the authors conclude that the puborectalis is not a part of the levator ani muscle. The concept that th...

chronic anal fissure is the most common cause of anal pain associated with internal anal sphincter hypertonia. reduction of hypertonocity is a special treatment for fissure healing. for this purpose chronic anal fissures were conventionally treated by anal dilatation or by lateral sphincterotomy. however, both of these methods may cause a degree of incontinence in some patients. the uptake of m...

OBJECTIVE To evaluate the effect of pelvic floor muscle exercises (PFME) for postpartum anal incontinence (AI). DESIGN A parallel two-armed randomised controlled trial stratified on obstetrical anal sphincter injury with primary sphincter repair and hospital affinity. SETTING Ano-rectal specialist out-patient clinics at two hospitals in Norway. POPULATION One hundred and nine postpartum w...

Neural control of the pelvic organs is one of the most intriguing in the body involving both autonomic and somatic components organized in the thoraco-lumbar (sympathetic), lumbosacral (somatic), and sacral (parasympathetic) spinal cord. Loss of supraspinal descending control and plasticity-mediated alterations at the level of the spinal cord, result in loss of voluntary control and in abnormal...

Aims: Dyschesia can be provoked by inappropriate defecation movements. The aim of this prospective study was to demonstrate dysfunction of the anal sphincter and/or the musculus (m.) puborectalis in patients with dyschesia using anorectal endosonography. Methods: Twenty consecutive patients with a medical history of dyschesia and a control group of 20 healthy subjects underwent linear anorectal...

I. Anatomy TWo sphincters guard the anal canal, the external sphincter and the internal sphincter. The external sphincter.?The external .sphincter is composed of the subcutaneous part, the superficial part, and the profundus or the deep part. The subcutaneous part is composed of muscle fibres surrounding the anal orifice, and is intimately connected with the skin. It is supplied by perineal bra...

OBJECTIVES To determine the prevalence of evidence of residual obstetric anal sphincter injury, to evaluate its association with anal incontinence (AI) and to establish minimal diagnostic criteria for significant (residual) external anal sphincter (EAS) trauma. METHODS This was a retrospective analysis of ultrasound volume datasets of 501 patients attending a tertiary urogynecological unit. A...

PURPOSE The effects of the Parks' anal retractor on anal sphincter function were studied in a prospective, randomized trial. A closed hemorrhoidectomy was performed intra-anally in 20 patients using the Parks' anal retractor; in 20 other patients, the procedure was done perineally without the use of a retractor. METHODS Anal manometry was performed before and at 6 and 12 weeks after hemorrhoi...