Anal et perforation vaginale

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Anal et perforation vaginale
Доступ к информационному ресурсу ограничен на основании Федерального закона от 27 июля 2006 г. № 149-ФЗ «Об информации, информационных технологиях и о защите информации».


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1 Department of Surgery, Derby Hospitals NHS Foundation Trust, Derby, UK. naseem.waraich@nottingham.ac.uk







Naseem G Waraich et al.






N Z Med J .



2007 .







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1 Department of Surgery, Derby Hospitals NHS Foundation Trust, Derby, UK. naseem.waraich@nottingham.ac.uk





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No abstract available.



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A middle-aged man was admitted to our hospital with abdominal pain and bleeding per rectum. Subsequent laparotomy indicated an established faecal peritonitis in relation to an anterior perforation of the upper rectum. He later volunteered that he had anal intercourse 2 days previously with a vibrator at an erotic party. His partner volunteered further information regarding devient practice such as regular insertion of other foreign objects (e.g. shower hose). Tearing of the rectal mucosa following such practices is a recognised complication. However mortality following foreign body perforation is reported as extremely rare in the medical literature. Surgical repair of rectal perforation and intensive treatment did not prevent development of acute respiratory distress syndrome (ARDS) and systemic inflammatory response syndrome (SIRS) hence leading to multiple organ dysfunction syndrome (MODS) and death. This case report highlights the seriousness of rectal injuries following unusual sexual practices. Death in this case can be attributed to the late presentation and established faecal peritonitis. Death due to retroperitoneal perforation following such accidents have been reported in the literature. However previously no cases have been recorded where death occurred due to anterior rectal wall perforation.


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Affiliation



1 From the Division of Female Pelvic Medicine and Reconstructive Surgery, Northwestern University, Chicago, IL.







Julia Geynisman-Tan et al.






Female Pelvic Med Reconstr Surg .



2018 May-Jun .







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1 From the Division of Female Pelvic Medicine and Reconstructive Surgery, Northwestern University, Chicago, IL.





Leader-Cramer A, Kenton K, Davé B, Gossett DR, Mueller M, Lewicky-Gaupp C.
Leader-Cramer A, et al.
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J Sex Med. 2016.

PMID: 27497647








Robinson PJ, Bell RJ, Christakis MK, Ivezic SR, Davis SR.
Robinson PJ, et al.
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Nichols CM, Gill EJ, Nguyen T, Barber MD, Hurt WG.
Nichols CM, et al.
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Meyer I, Tang Y, Szychowski JM, Richter HE.
Meyer I, et al.
Female Pelvic Med Reconstr Surg. 2015 Nov-Dec;21(6):339-42. doi: 10.1097/SPV.0000000000000189.
Female Pelvic Med Reconstr Surg. 2015.

PMID: 26506162
Free PMC article.







Pennesi CM, English EM, Bell S, Lossie AC, Quint EH, Swenson CW.
Pennesi CM, et al.
Am J Obstet Gynecol. 2021 Jul;225(1):70.e1-70.e12. doi: 10.1016/j.ajog.2021.02.020. Epub 2021 Feb 20.
Am J Obstet Gynecol. 2021.

PMID: 33621544








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Objective:


The aim of the study is to investigate the relationship between anal penetrative intercourse (API) and pelvic floor symptoms, specifically, anal incontinence (AI).




Methods:


This was an institutional review board-approved, cross-sectional, e-mail survey of women enrolled in the Illinois Women's Health Registry. Participants were anonymously queried about their sexual practices and the effects of these on bowel and bladder symptoms. Urinary symptoms were assessed using the urogenital distress inventory-6 and bowel symptoms with the fecal incontinence severity index (FISI).




Results:


One thousand three women (mean age of 46 ± 15 years) completed the survey. Eighty percent were white, 56% were married, and 99% reported ever being sexually active. Thirty-two percent had API at least once, and 12% considered it "part of their sexual practice." Sixty percent of the cohort reported a bothersome urinary symptom on the urogenital distress inventory-6, 70% reported AI on the FISI, and 15% reported fecal incontinence. Of women who engaged in API, 18% reported it changed their stool consistency, and 10% reported it caused AI. Having engaged in API within the last month was correlated with higher FISI scores (P = 0.05) and with fecal incontinence on the FISI (28.3% vs 14.4%; P = 0.01; odds ratio, 2.48). In addition, API was more commonly practiced among women who reported that vaginal intercourse caused dyspareunia (17% vs 12%, P = 0.05) or changes in bladder symptoms such as urgency or dysuria (44% vs 30%, P < 0.001).




Conclusions:


Self-reported AI and FI (as measured by the FISI scores) are higher in women who have had API, and frequency of API may be important in determining the risk of bowel symptoms.


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