OBJECTIVE To re-evaluate previously published findings from an uncontrolled before-after evaluation of an intervention programme to reduce the incidence of anal sphincter tears. A key component of the programme was the use of a hands-on technique where the birth attendant presses the neonate's head during the final stage of delivery while simultaneously supporting the woman's perineum with the ...

This study was conducted to determine the safety and efficacy of injectable bulking agents. A total of 13 procedures were performed on 11 patients with faecal incontinence during 2002 to 2007. Patients with internal anal sphincter defect and low incontinence score (Cleveland score < 10) revealed improvement. Patients with higher incontinence score and external sphincter defect secondary to obst...

PURPOSE To estimate the risk of recurrent fissure in ano after sphincter preserving treatments. METHODS A retrospective case note review, combined with a telephone survey was conducted for all patients treated for a chronic anal fissure between 1998 and 2008. RESULTS Six hundred and twelve patients (303 women: mean age, 39 years; range, 16-86 years) were treated for chronic anal fissure bet...

The study proposed to evaluate the feasibility of predicting sphincter-sparing surgery (SSS) preoperatively in low-middle rectal cancer by using magnetic resonance (MR).The study included both retrospective and prospective design. In the retrospective design, the distance from lower edge of tumor to upper margin of the internal sphincter (Dis1) and distance to anal verge (Dis2) were measured on...

The etiology and pathogenesis of anal fissure (AF) is one of the most common causes of severe anal pain yet has never been fully understood. Factors which predispose people to developing AF include diarrhea, constipation, childbirth, medication as well as constant saddle vibration (amongst professional mountain-bikers) and using a jet of water from a bidet-toilet. For many years, it has been ge...

BACKGROUND AND AIMS Anal sphincter weakness and rectal sensory disturbances contribute to faecal incontinence (FI). Our aims were to investigate the relationship between symptoms, risk factors, and disordered anorectal and pelvic floor functions in FI. METHODS In 52 women with "idiopathic" FI and 21 age matched asymptomatic women, we assessed symptoms by standardised questionnaire, anal press...

Large haemorrhoids. The dentate line, which should be halfway up the anal canal, can be clearly seen separating the prolapsed anal cushions (autonomic innervation) from the secondarily congested external plexus (somatic innervation). Haemorrhoids and related conditions are not popular with patients or doctors and are commonly relegated for treatment to a junior member of the surgical team. This...