By Donato F. Altomare, Filippo Pucciani
The pathophysiology of this disabling situation continues to be doubtful and its medical and instrumental diagnostic evaluation should be clarified. definitely the right surgical or scientific technique is far debated and hasn't ever been definitively acknowledged. The rarity of the situation prevents randomised managed trials from being performed in one establishment, so the evaluations of exceptional leaders during this box are rather very important. This textbook addresses the way in which of comparing sufferers with rectal prolapse, the underlying pathophysiology, the various surgical ways, the predicted sensible effects after surgical procedure and the administration of complicated scientific stipulations linked to this situation.
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Additional resources for Rectal prolapse: diagnosis and clinical management
Sample text
Am J Obstet Gynecol 180:815–823 4 An Overview of Neurophysiologic Tests in Rectal Prolapse Carlo Ratto Introduction Diagnostic assessment in patients with rectal prolapse is a debatable field due to the very different clinical presentation of this condition and different preferences towards the variety of available diagnostic tests. Only full-thickness protrusion of the entire rectal wall through the anal canal should fall under the definition of “rectal prolapse”. However, internal rectal intussusception is very often included in this definition [1] because it is regarded as an early stage of overt rectal prolapse.
1 mm in diameter) covered by an insulating resin, which is able to uptake electrical activity of the small area into which it has been inserted. This needle is unable to record single muscle-fibre action potentials. Under the guidance of digital anal exploration, the needle must be inserted into the external sphincter or puborectalis muscle. Recordings from the four anal canal quadrants should be obtained. This procedure is quite uncomfortable for the patient. The electrode could slide in a different position during trace acquisition and, even if multiple recording samples are taken, the mapping obtained is far from being considered sufficient to delineate accurately the real area of normal and abnormal muscle.
Directly outside the mucosa, two to three triangular-shaped images of intermediate echogenicity, which represent the submucosa, are found. The internal anal sphincter is the innermost muscular structure, which is the continuation of the circular part of the rectal mucosa wall. It is clearly seen as a symmetric, 3-mmthick hypoechoic ring completely encircling the submucosa. Outside the internal sphincter is the mixed echogenic intersphincteric space. Within this space is the relatively hypoechoic longitudinal muscle, which is a continuation of the longitudinal part of the rectal muscular wall.