OBJECTIVE To review systematically techniques proposed to prevent perineal trauma during childbirth and meta-analyze the evidence of their efficacy from randomized controlled trials. DATA SOURCES MEDLINE (1966-1999), the Cochrane Library (1999 Issue 1), and the Cochrane Collaboration: Pregnancy and Childbirth Database (1995); and reference lists from articles identified. Search terms included...

Spontaneous laceration of the ascending aorta may result in (1) through-and-through laceration causing hemopericardium, (2) limited intramural dissection of blood (incomplete dissecting aneurysm), or (3) classical dissecting aneurysm. The latter is the most common manifestation. Background conditions include either extensive cystic medial necrosis (as may be seen in Marfan's syndrome) or hypert...

CASE REPORT A 19-year-old man presented to our outpatient clinic with a perineal mass and discomfort. Examination showed an empty and poorly developed left hemiscrotum. The contralateral testis was in its normal location in the right hemiscrotum (Figure 1). An oval-shaped soft mass was detected in the perineum measuring 4 × 5 × 6 cm. A clinical diagnosis of perineal ectopic testis was made. We ...

OBJECTIVE Spinal manipulation with high-velocity and low-amplitude (HVLA) manipulation is frequently used for the treatment of lumbopelvic pain; however, the effect on the pelvic floor has been poorly studied in the past. The objective of this study was to quantify the intravaginal pressure (IVP) and the basal perineal tonus (BPT), measured in terms of pressure, before and after the HVLA manipu...

BACKGROUND Approximately 85% of vaginal deliveries are accompanied by perineal trauma. The objective of this trial is to compare the incidence and degree of perineal trauma after primary delivery of the anterior compared with the posterior shoulder during vaginal birth. The hypothesis is that primary delivery of the posterior shoulder reduces the rate and degree of perineal trauma. METHODS/DE...

BACKGROUND Corticosteroids have anti-inflammatory, analgesic and antiemetic effects but causes severe perineal symptoms when given intravenously. Simultaneous administration of dexamethasone and fentanyl have been known to decrease the duration of perineal pain but its role in alleviating perineal pain has not been studied. Therefore, we hypothesized that fentanyl pretreatment could prevent the...

BACKGROUND The accurate assessment and appropriate repair of birth related perineal trauma require high levels of skill and competency, with evidence based guideline recommendations available to inform UK midwifery practice. Implementation of guideline recommendations could reduce maternal morbidity associated with perineal trauma, which is commonly reported and persistent, with potential to de...

183 Im ages is large and deep. In these cases, it is usually detected intraoperatively. However, smaller tears are detected during the postoperative period. The exact site and size of the abovementioned laceration is determined by bronchoscopy; this knowledge helps in planning the therapeutic approach. Nonoperative indications are stable vital signs, no difficulty ventilating while intubated or...

background & aim: episiotomy is a common medical procedure for widening the perineum. in fact, perineal pain is the most common complaint after episiotomy. therefore, it is important to determine factors associated with postoperative pain following episiotomy in order to provide comfort for women after delivery. this study aimed to investigate factors associated with postoperative pain followin...

Given the knowledge that the ischiocavernous and bulbocavernous muscles are involved in the erection of the penis, we studied the voluntary contractile activity of the perineal ̄oor muscles in sexually potent and impotent men to investigate whether or not a different muscular ef®ciency can be found in these subjects. The activity of perineal ̄oor muscles was studied in 76 sexually potent men and ...