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Related Concept Videos

Assessment of the Rectum and Anus01:25

Assessment of the Rectum and Anus

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Evaluating the rectum and anus plays a crucial role in conducting a thorough physical examination of the gastrointestinal system. Although it may be uncomfortable and often embarrassing for the patient, it holds immense diagnostic value, particularly in detecting gastrointestinal diseases and abnormalities. This guide will explain how to perform this assessment using inspection and palpation methods.
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Meaning of Cystoscopic Examination:Cystoscopy is an essential diagnostic tool in urology that is used to assess the structure and function of the genitourinary system. It provides a direct view of the urethra, bladder, and, in some cases, the ureteral openings. This procedure helps detect structural abnormalities, infections, cancers, and blockages in the urinary tract. There are two types of cystoscopy:Flexible cystoscopy is commonly performed in outpatient settings due to its less invasive...
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Inflammatory Bowel Disease V: Surgical Management01:21

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Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
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Imaging Studies VI: Voiding Cystourethrography and Cystography01:22

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Voiding Cystourethrography (VCUG) and Cystography are specialized radiographic procedures used to examine the structure and function of the bladder and urethra.Voiding Cystourethrography (VCUG)A Voiding Cystourethrogram (VCUG) is a diagnostic imaging procedure that assesses the anatomy and function of the lower urinary tract. It focuses on the bladder, bladder neck, and urethra, helping detect abnormalities such as vesicoureteral reflux (VUR)—the backward or reverse flow of urine into the...
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Urinary Tract Calculi VI: Surgical Management01:25

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Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
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Urinary Bladder01:23

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The urinary bladder is a hollow, muscular sac that temporarily stores urine before it is expelled from the body. It can hold approximately 600 mL of urine prior to micturition. The bladder is retroperitoneal and located behind the pubic symphysis in the pelvic floor.
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Anorectal dysfunction after radical cystectomy for bladder cancer.

Fredrik Liedberg1,2, Oskar Hagberg1,3, Gediminas Baseckas1,2

  • 1Institution of Translational Medicine, Lund University, Malmö, Sweden.

Scandinavian Journal of Urology
|January 12, 2022
PubMed
Summary

Rectal cancer surgery (RC) can lead to flatus incontinence and decreased rectal sensation in 15% of patients. These issues may stem from reduced anal resting pressures and altered rectal sensation post-surgery.

Keywords:
Bladder cancerLARS-scoreSt Mark’s scorecystectomymanovolumetryultrasound

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Area of Science:

  • Colorectal Surgery
  • Gastroenterology
  • Patient-Reported Outcomes

Background:

  • Rectal cancer surgery (RC) can significantly impact anorectal function.
  • Assessing postoperative anorectal dysfunction is crucial for patient quality of life.

Purpose of the Study:

  • To prospectively evaluate anorectal dysfunction after RC using patient-reported outcomes and objective measures.
  • To compare pre- and postoperative anorectal function at 12 months post-surgery.

Main Methods:

  • Prospective study of 44 patients undergoing RC.
  • Utilized Low Anterior Resection Syndrome (LARS) score, St. Mark's score, manovolumetry, and endoanal ultrasound.
  • Preoperative and 12-month postoperative assessments were conducted.

Main Results:

  • 15% of patients reported flatus incontinence post-RC (LARS-score).
  • Median anal resting pressure decreased from 57 to 46 mmHg.
  • Rectal sensation decreased, indicated by increased volumes/pressures for first desire, urgency, and maximum tolerance.

Conclusions:

  • Postoperative flatus incontinence affects approximately 15% of patients after RC, correlating with reduced anal resting pressures.
  • Decreased rectal sensation may contribute to patient-reported anorectal dysfunction following RC.