Erschienen in:
17.01.2019 | Technical Advances
Levator ani repair by transvaginal approach
verfasst von:
F. Ris, M. Alketbi, C. R. Scarpa, E. Gialamas, A. Balaphas, J. Robert-Yap, K. Skala, G. Zufferey, N. C. Buchs, B. Roche
Erschienen in:
Techniques in Coloproctology
|
Ausgabe 2/2019
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Excerpt
Levator ani injury in women is mainly caused by obstetrical damage, but any kind of direct perineal trauma can be also the cause (e.g., pelvic fracture in a road accident). The symptoms of levator ani damage are essentially anal incontinence, dyschezia, pain, colpophony (sound from the vagina at unexpected moments) and/or sexual dysfunction. Indications for a levator ani, mostly a puborectalis repair, are symptomatic damage of the muscle resulting in a retraction and a defect of the levator ani on the damaged side. The damage can be assessed by a simple inspection, with a clear deviation of the anus from the midline, as shown in Fig.
1. By careful vaginal and rectal examination, it is possible to feel the defect. The damage can be confirmed by perineal, endoanal or transvaginal ultrasound and magnetic resonance imaging (MRI). …
