Abstract:
:Rectovaginal fistulas and chronic anal sphincter lacerations are uncommon complications that are most often secondary to vaginal delivery, gynecologic surgery, and inflammatory bowel disease. In this chapter, we will review the pertinent anatomy, focusing on the 6 structures that should be considered during the repair and surgical techniques to promote restoration on normal anatomy and function. Key concepts include a tension-free repair, meticulous hemostasis, and postoperative bowel management.
journal_name
Clin Obstet Gynecoljournal_title
Clinical obstetrics and gynecologyauthors
Delancey JO,Berger MBdoi
10.1097/GRF.0b013e3181cf7488subject
Has Abstractpub_date
2010-03-01 00:00:00pages
134-44issue
1eissn
0009-9201issn
1532-5520pii
00003081-201003000-00014journal_volume
53pub_type
杂志文章,评审abstract::An "adnexal mass" is a common specimen encountered in the daily pathology practice. Although most are benign, the incidence of malignancy increases with age, and approximately 30% are malignant in postmenopausal females. Herein we describe the salient macroscopic and microscopic features of the most prevalent adnexal ...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0000000000000082
更新日期:2015-03-01 00:00:00
abstract::One in 1000 pregnancies is complicated with cancer with the most common tumors being breast cancer, cervical cancer, thyroid, leukemia, lymphoma, and ovarian cancer. It is often assumed that cancer during pregnancy necessitates sacrificing the well-being of the fetus but in most cases appropriate treatment can be offe...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0b013e318236e9f9
更新日期:2011-12-01 00:00:00
abstract::The telephone will become the centerpiece of ambulatory care services. As such, a pertinent aspect of office procedures will necessarily include a protocol to manage and document telephone calls. Encourage your office staff to use good telephone manners, as listed in Table 5. The net result should be a reduction in te...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-199809000-00018
更新日期:1998-09-01 00:00:00
abstract::The responsibility of the obstetrician is to identify during the first trimester women who are carriers for thalassemia. When she has been identified, the father of the baby should be screened and if he is also a carrier, the couple should be offered prenatal diagnosis. In the majority of cases, prenatal diagnosis can...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-199509000-00008
更新日期:1995-09-01 00:00:00
abstract::Once the decision to perform a hysterectomy has been made, the type and route of hysterectomy must be chosen, and efforts made to accomplish the surgery as safely as possible. Hysterectomy can be performed vaginally, abdominally with laparoscopic or robotic assistance, or open. The main goal of gynecologic surgeons sh...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/GRF.0000000000000283
更新日期:2017-06-01 00:00:00
abstract::Genitourinary syndrome of menopause (GSM) describes a collection of exam findings and bothersome symptoms associated with estrogen deficiency involving changes to the labia, introitus, clitoris, vagina, urethra, and bladder. Vulvovaginal atrophy is a component of GSM. GSM is a highly prevalent medical condition with a...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0000000000000380
更新日期:2018-09-01 00:00:00
abstract::Intrahepatic cholestasis of pregnancy is a common disorder of pregnancy manifested by pruritus and elevated bile acids. The etiology of cholestasis is poorly understood and management is difficult due to the paucity of data regarding its diagnosis, treatment, and related adverse outcomes. In this article, we review th...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/GRF.0000000000000495
更新日期:2020-03-01 00:00:00
abstract::The interest in studying routine ultrasound in pregnancy has provided useful results that can be applied to practice. There is no consistent evidence of risk caused by ultrasound, neither biologic risk for the fetus nor increased use of health services as a result of ascertained conditions. There is also no consistent...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-199912000-00003
更新日期:1999-12-01 00:00:00
abstract::In summary, accurate identification of fetal growth disorders remains a difficult clinical challenge. Many diagnostic parameters have been devised to diagnose these conditions, however, no single test alone allows a confident antenatal diagnosis of IUGR or macrosomia to be established. Until new criteria or new method...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-198803000-00007
更新日期:1988-03-01 00:00:00
abstract::In the last 10 years, expanded preconception carrier screening has become widely available and helps patients/couples make more informed decisions with regard to their reproductive options and facilitates more effective preconception planning, prenatal diagnosis, condition-specific counseling, and condition-specific c...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0000000000000437
更新日期:2019-06-01 00:00:00
abstract::Predelivery diagnosis of placenta accreta, increta, and percreta (from here referred to as placenta accreta, unless otherwise noted) has increasingly created opportunities to optimize antenatal management. Despite the increased frequency of placenta accreta today, occurring in as many as 1 in 533 to 1 in 272 deliverie...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0000000000000394
更新日期:2018-12-01 00:00:00
abstract::The final decision to perform a certain method of hysterectomy customarily mirrors experience and level of comfort with a particular surgical approach in the context of the patient's condition and indication for surgery. Given the morbidity and recovery associated with a laparotomic incision, every effort should be ma...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/01.grf.0000211946.51712.42
更新日期:2006-12-01 00:00:00
abstract::In our proof-of-concept study of 1 patient with stage IIIC carcinosarcoma of the ovary, we discovered a rare mutation in the tumor suppressor, TP53, that results in the deletion of N131. Immunofluorescence imaging of the organoid culture revealed hyperstaining of p53 protein. Computational modeling suggests this resid...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/GRF.0000000000000516
更新日期:2020-03-01 00:00:00
abstract::Recent rise in rates of opiate replacement therapy among pregnant women have resulted in increasing number of infants requiring treatment for neonatal abstinence syndrome (NAS). Short-term and long-term developmental outcomes associated with prenatal opiate exposure are discussed, including symptoms and severity of NA...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0b013e31827feea4
更新日期:2013-03-01 00:00:00
abstract::The advent of ultrasound fetal imaging and the evolution of dynamic imaging (real-time) methods have opened great new vistas in which fetal responses can be monitored with remarkable precision and clarity. Contained within this new wealth of information may lie the key to direct determination of the fetus at risk for ...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-199503000-00006
更新日期:1995-03-01 00:00:00
abstract::Despite advances in estimating prognosis and predicting response to adjuvant systemic therapy, the status of the axillary lymph nodes remains a critical component in initial surgical planning and in determining therapeutic strategies for patients with breast cancer. Buoyed by evidence from multi-institutional randomiz...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0000000000000232
更新日期:2016-12-01 00:00:00
abstract::Urinary tract infection in women has its origin, predominantly, via ascending bacteria from the periurethral microflora. Asymptomatic bacteriuria, except for the pregnant patient, need not be treated. E. coli is the most common bacterium to cause UTIs, and is usually susceptible to oral antibiotics. Patients who are h...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-199809000-00030
更新日期:1998-09-01 00:00:00
abstract::New reproductive genetics means recently developed techniques to prevent the birth of children with specific defects or genetic diseases by testing individuals for sickle cell anemia, the thalassemias, Tay-Sachs disease, cystic fibrosis, or Down syndrome. Third World health services have many deficiencies with high m...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-199309000-00007
更新日期:1993-09-01 00:00:00
abstract::Ovarian cancer accounts for approximately 22,000 cases annually in the United States. Although the vast majority of ovarian cancers occur in postmenopausal women and are of advanced stage, a significant subset occurs in young women. Among those subtypes having a predisposition for young women are malignant ovarian ger...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0b013e318248045b
更新日期:2012-03-01 00:00:00
abstract::The pharmacology and potential uses of RU-486, the only anti- progesterone to reach clinical trials, including luteolytic, abortifacient, menstrual regulator, postcoital contraceptive, oral contraceptive and other uses, are reviewed. RU-486 acts on the progesterone receptors in the endometrium, specifically the decid...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00003081-198906000-00024
更新日期:1989-06-01 00:00:00
abstract::There has been a steady decline in breast cancer mortality that has led to a significant increase in the number of patients surviving breast cancer. We will review in this manuscript the evidence and guidelines for posttreatment surveillance of patients with breast cancer as well as the management options for patients...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0000000000000243
更新日期:2016-12-01 00:00:00
abstract::Ovulation induction is the principal infertility treatment for women with polycystic ovarian syndrome (PCOS). Among PCOS patients who are overweight or obese, weight loss is the most physiologic method of inducing ovulation. For women in whom weight loss is not possible, or for lean women with PCOS, clomiphene citrate...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/GRF.0b013e31802f361e
更新日期:2007-03-01 00:00:00
abstract::The foregoing discussion is consistent with the following conclusions: First structural differentiation of the gonads, consonant with chromosomal sex of human fetuses, requires complex interactions of primordial germ cells with coelomic and mesonephric epithelial cells and mesenchymal cells in the genital ridge. The m...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1980-09-01 00:00:00
abstract::The development of the fetal adrenal medulla can be considered an integral part of the complex process of maturation and preparation of the fetus for extrauterine life. Our understanding of the fetal sympathoadrenal function is facilitated by the relative separation that exists between the maternal and fetal catechola...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:
更新日期:1980-09-01 00:00:00
abstract::A comprehensive knowledge of the boundaries, contents, and interactions between surgical spaces is essential to safely and effectively perform mesh-augmented prolapse repairs and anti-incontinence procedures. This knowledge is also critical when managing intraoperative and postoperative complications such as bleeding,...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0b013e31828e629c
更新日期:2013-06-01 00:00:00
abstract::Physicians and other health care providers requesting dual-energy x-ray bone density studies must be able to critically review and interpret such studies. This requires an understanding of the computerized result components of the studies and how such data can be applied in clinical practice. The timing and interpreta...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0b013e3182a8240c
更新日期:2013-12-01 00:00:00
abstract::Uterine leiomyomas pose a significant health issue to reproductive-age women. Many women desire uterine conservation, and previously safe and efficacious therapies have been limited. Magnetic resonance-guided focused ultrasound surgery is a new noninvasive therapy that has been proven to be both safe and efficacious i...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/GRF.0b013e318161e91f
更新日期:2008-03-01 00:00:00
abstract::Cardiac disease is a leading cause of morbidity and mortality in pregnant women. An increased prevalence of the cardiovascular disease has been found in women of childbearing age, in which the responsibility of the treating physician extends to the mother and to the unborn fetus. As a result, care of these high-risk p...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/GRF.0000000000000579
更新日期:2020-12-01 00:00:00
abstract::The recent published literature dealing with urinary tract calculi during pregnancy has been summarized. Our own experience with 17 patients, (0.08% of the deliveries) in a recent 12-year interval has been described. Emphasis must be placed on the safety and limitations of renal ultrasonography. Excretory urography sh...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1985-06-01 00:00:00
abstract::Maternal mortality is a complex problem requiring complex responses. Nevertheless, every intervention must operate through one of 3 pathways: preventing pregnancy, preventing complications, or preventing death when obstetric complications occur. We describe interventions following each pathway and assess their evidenc...
journal_title:Clinical obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/GRF.0b013e3181a4bddb
更新日期:2009-06-01 00:00:00