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Characterization of perineum Elasticity and Pubic Bone-Perineal Critical Distance with a Novel Tactile Probe: Results of an Intraobserver Reproducibility Study

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Open Journal of Obstetrics and Gynecology 2020年第4期10卷 493-503页

作者： Justin S. Brandt Todd Rosen Heather Van Raalte Viktors Kurtenos Vladimir Egorov Department of Obstetrics Gynecology and Reproductive Sciences Division of Maternal-Fetal Medicine Rutgers Robert Wood Johnson Medical School New Brunswick NJ USA. Princeton Urogynecology Princeton NJ USA. Advanced Tactile Imaging Inc. Trenton NJ USA.

Background: Tactile imaging provides biomechanical mapping of soft tissues. Objective biomechanical and anatomical assessment of critical structures within the vagina and pelvis may allow development and validation of a clinical tool that could assist with clinical decisions regarding obstetrical procedures and mode of delivery. Objective: To assess intraobserver reproducibility of measurements of perineal elasticity and pubic bone-perineal critical distance with a novel tactile probe in pregnant women. Methods: An Antepartum Tactile Imager (ATI) was designed with a vaginal probe resembling a fetal skull. The probe comprises 128 tactile sensors on a double curved surface and measures 46 mm in width and 72 mm in length. The probe has a motion tracking sensor that allows acquisition of 3D tactile images. There were two arms of the study. In the first arm, biomechanical mapping of the perineum and pelvic bone location was performed in 10 non-pregnant women for purposes of demonstrating safety and feasibility. In the second arm, biomechanical mapping was performed in 10 pregnant women to explore intraobserver reproducibility. Each subject had two standardized examinations over 3 - 5 minutes by the same observer. Examination comfort and pain levels were assessed by post-procedure survey. Reproducibility was analyzed by intraclass correlation coefficients (ICC) with 95% confidence intervals and Bland-Altman plots. Bias and the 95% limits of agreement were also calculated. Results: The safety and feasibility arm of the study demonstrated high degree of safety and tolerability and reliable acquisition of tactile signals. In the reproducibility arm, 10 pregnant women were recruited at mean gestational age of 34.2 ± 6.5 weeks. The mean perineum elasticity (Young’s modulus, E) was 9.8 ± 5.9 kPa, and the mean pubic bone-perineal critical distance (D) at 20 kPa load was 34.6 ± 6.2 mm. The ICC was 0.97 [95% confidence interval (CI) 0.91, 0.99] and 0.82 [CI 0.44, 0.95] for E and D

关键词： Perineal Elasticity Tactile Imaging Elastography Antepartum Predictive Model Delivery Mode perineum Maternal Birth Trauma

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Survival following an impalement injury through the perineum in association with high voltage electrical burns: A case report

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Journal of Acute Disease 2017年第2期6卷 82-84页

作者： Joseph Yorke Pius Agbenorku Ronald Awoonor-Williams Kofi Baah Nyamekye George Amoah Offoe Michael Adinku Charles Appiah Amoah Edward Boateng Esinam Anita Agbeko Papa Kwesi Sonsomir Fiifi-Yankson Dorcas Ahulu Daniel Anning Gyawu Dennis Afful Yorke Department of Surgery School of Medical SciencesCollege of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana General Surgery Unit Directorate of SurgeryKomfo Anokye Teaching HospitalKumasiGhana Reconstructive Plastic Surgery&Burns Unit Department of SurgerySchool of Medical SciencesCollege of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana Urology Unit Department of SurgeryKomfo Anokye Teaching HospitalKumasiGhana Directorate of Anaesthesia and Intensive Care Unit Komfo Anokye Teaching HospitalKumasiGhana School of Medical Sciences College of Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana

We reported a case of a 30-year-old man who reportedly sustained electrical burns and fell from a high voltage electric pole about 50 meter high onto a metal that caused impalement injury. In addition, he sustained full-thickness burns of the right upper limb (7%), the right hemithorax, the perineum (sparing the penis), the anterior abdominal wall and the lateral aspect of both thighs. There was 43% burned surface area in total. Radiographic examination revealed a slender curved object extending from his perineum into the pelvis. The management of this case was a challenging one which was described in this article.

关键词： Impalement injury High voltage electrical burns perineum Pelvis

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Prevalence, Associated Risk Factors and Maternal Outcomes of Lower Genital Tract Injuries in the Bamenda Regional Hospital

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Open Journal of Obstetrics and Gynecology 2022年第5期12卷 417-433页

作者： Takang Ako Wiliiam Leke J. I. Robert Department of Obstetrics and Gynecology Faculty of Health Sciences University of Bamenda Bamenda Cameroon Department of Obstetrics and Gynecology Faculty of Medicine and Biomedical Sciences University Yaounde 1 Yaounde Cameroon

BACKGROUND: Tears of the genital tract are lesions resulting from the breakage of the continuity of the lower genital tract during childbirth. These injuries are associated with high maternal morbidity or mortality if severe, poorly managed or delayed in repair. It is a frequent complication of vaginal delivery. This study was aimed at determining the prevalence, demographic characteristics, risk factors, patterns and the t-term maternal outcomes of lower genital tract injuries in the labour room and the post-natal ward of the Bamenda Regional Hospital. METHODS: This was a hospital-based cross-sectional study of women managed for genital tract injuries following vaginal birth in the Bamenda Regional Hospital (BRH) from March 2019 to July 2019. A non-probabilistic, consecutive and exhaustive sampling technique was used to select participants (sample size estimated at 237). Among those selected were women who had a vaginal birth. However, the researchers’ interest was particularly centered on the women who had genital tract injuries. Data was collected using a pretested questionnaire and analyzed using the SPSS version 22 software. RESULTS: In total, 310 participants were included in this study. The mean age of the participants was 26.1 years (SD = 5.2), while the median age was 25 years (interquartile range = 22 - 29). Of the 310 participants included in the study, 128 developed a birth tract injury giving a prevalence of 41.3% (95% CI, 35.8 - 47.0). The most common type of injury was spontaneous tears (33.9%), the majority of which were perineal (30.6%) compared to episiotomies (7.4%). Most perineal tears were first degree tears (23.2%) followed by second-degree tears (6.8%). Third-degree perineal tears were rare (0.6%). We did not have any cases of fourth-degree perineal tears. We also encountered a few cases of cervical tears (0.6%). The factors associated with birth tract injury were assessed using bivariate and multiple logistic regression analysis. On bivariate

关键词： Genital Tract Episiotomy Prevalence perineum Cervix Vagina

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Biobrane^(TM) for burns of the pubic region: minimizing dressing changes

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Military Medical Research 2019年第1期6卷 89-92页

作者： Jia-Jun Feng Jia Le See Abby Choke Adrian Ooi Si Jack Chong Department of Plastic Reconstructive and Aesthetic Surgery Singapore General Hospital University of Auckland Faculty of Medical and Health Sciences

Background: The pubic region is often involved in accidental hot water or soup-spill burns. Most of these wounds are superficial partial thickness burns. Due to their proximity to the urinary system, as well as vaginal and anal openings,these burns are easily contaminated. Daily dressings are routinely prescribed as the sole treatment. The cumbersome dressing process is uncomfortable and embarrassing for patients. Biobrane^(TM) is a bilayered biosynthetic dressing. Its coverage of superficial partial thickness burns promotes wound healing and allows one-time *** presentations: We report two patients who suffered superficial dermal burns over their pubic region. One patient had 23% total body surface area(TBSA) burns over her lower abdomen, both thighs and pubic region. The second patient had 10% TBSA burns that involved her perineum and the medial sides of both thighs and *** were managed with the standard resuscitation protocol in the initial phase. Their burn injuries were managed by shaving, Foley catheterization and Biobrane^(TM) coverage. Their wounds healed uneventfully without *** epithelization was achieved by post-operative day seven. Both patients consented to medical photography and academic ***: Shaving and catheterization improved the hygiene of the burns of the pubic area. The Biobrane^(TM)method circumvents the need of regular dressing changes, eliminating the pain due to dressing changes and preserving patient dignity.

关键词： Pubic Thermal burns perineum Dressing BiobraneTM

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肛门生殖器距离与雄激素受体基因CAG重复序列长度之间的关系

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Asian Journal of Andrology 2013年第2期15卷 286-289,I0010页

作者： Michael L Eisenberg Tung-Chin Hsieh Alexander W Pastuszak Matthew G McIntyre Rustin C Waiters Dolores J Lamb Larry I Lipshultz Department of Urology Stanford University School of Medicine Stanford CA 94305 USA Department of Urology Baylor College of Medicine Houston TX 77030 USA

Anogenital distance （AGD） is used to define degree of virilization of genital development, with shorter length being associated with feminization and male infertility. The first exon of the androgen receptor （AR） consists of a polymorphic sequence of cytosine-adenineguanine （CAG） repeats, with longer CAG repeat lengths being associated with decreased receptor function. We sought to determine if there is an association between AGD and AR CAG repeat length. A cross-sectional, prospective cohort of men evaluated at a urology clinic at a single institution was recruited. AGD （the distance from the posterior scrotum to the anal verge） and penile length （PL） were measured. Sanger DNA sequence analysis was used to define CAG repeat length. AGD and CAG repeat lengths in 195 men were determined. On unadjusted analysis, there was no linear relationship between CAG repeat length and PL （P=0.17） or AGD （P=-0.31）. However, on sub-population analyses, those men with longer CAG repeat lengths （〉26） had significantly shorter AGDs compared to men with shorter CAG repeat lengths. For example, the mean AGD was 41.9 vs. 32.4 mm with a CAG repeat length ≤26 vs. 〉26 （P=0.01）. In addition, when stratifying the cohort based on AGD, those with AGD less than the median （i.e. 40 mm） had a longer CAG repeat length compared to men with an AGD 〉40 mm （P=-0.02）. In summary, no linear relationship was found between AGD and AR CAG repeat length overall.

关键词： androgen receptor (AR) anogenital distance (AGD) genitalia penile length (PL) perineum

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Professional’s skills in assessment of perineal tears after childbirth—A systematic review

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Open Journal of Obstetrics and Gynecology 2013年第4期3卷 7-15页

作者： Ann Morris Marie Berg Anna Dencker Centre for Person-Centred Care Institute of Health and Care Sciences Sahlgrenska Academy University of Gothenburg Gothenburg Sweden

Perineal tears are one of the most common complications of vaginal births and may cause discomfort and pain long time after childbirth. Visual and digital examination of perineal tears is the most common way to assess and classify a perineal tear. Recent research indicates that many tears diagnosed are misclassified. The aim of this systematic literature review was to outline research that investigates healthcare professionals’ clinical knowledge in assessment and classification of perineal tears in connection with childbirth. Searches were performed in PubMed and CINAHL. Six studies on the topic were identified and ?used to collect data for questionnaires. An integrative review was used in the analysis. Poor knowledge in perineal anatomy and lack of training in clinical assessment and classification of perineal trauma was evident among both physicians and midwives. These findings indicate that healthcare providers lack adequate knowledge and that they make incorrect assessments and errors in classification of perineal tears. The training in assessment and classification is crucial. Midwives are in a unique position to improve the standard of care in this field since they are often the first and many times the only to assess the injury.

关键词： perineum Injuries Perineal Tears Obstetrics/Midwifery Education Clinical Competence Review Childbirth

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Tolerability and hydrating effects of an anti-aging gynaecological collagen cream in women in menopause

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Open Journal of Obstetrics and Gynecology 2014年第3期4卷 130-138页

作者： Andrea F. D. Di Stefano Milko M. Radicioni Andrea Vele Anna Mancarella Eberhardt Giorgio Caccia Francesca Focanti Enrica Salvatori Aziende Chimiche Riunite Angelini Francesco (ACRAF) S.p.A. Santa Palomba Rome Italy Chiasso Switzerland CROSS Research S.A. Arzo Switzerland Service for Gynaecology and Obstetrics Ospedale Regionale di Mendrisio Mendrisio Switzerland

Background and Aims: A gynaecological cream containing collagen, phytocollagen, hyaluronate and vitamins was investigated in women in menopause. Methods: The cream was daily applied to the vaginal mucosa and the perineal skin as well as to the abdominal skin (healthy skin used as control) for 1 week and then on alternate days for other 2 weeks. Skin hydration and viscoelasticity were measured at baseline and after 8 and 21 days by Corneometer? CM 825 and Cutometer? MPA 850, respectively. The product use comfort and the moisturising of the vaginal mucosa were evaluated by the volunteers through a questionnaire and a visual analogue scale, respectively. Results: The local tolerability was excellent for nearly all of the volunteers (90% - 95%) and according both to dermatologist’s and gynaecologist’s evaluation. Related adverse reactions had a frequency of 15% (10% vulvovaginal burning sensation and 5% vulvovaginal discomfort). The topical hydration increased both in the perineal and the abdominal skin. Hydration increase vs. baseline was more marked on day 8 than on day 21 and was significant in the abdominal skin (p-value perineum and R0 increase in the abdomen. Conclusions: The tested cream represents a safe product with proven moisturising effect towards the vaginal mucosa when daily applied by menopausal women.

关键词： Skin Hydration Vaginal Moisturiser Skin Viscoelasticity Corneometer Cutometer perineum

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Aggressive angiomyxoma of the vagina

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中华医学杂志(英文版) 2014年第5期127卷 991-991页

作者： Zhu Honglan Wang Shijun Department of Gynecology and Obstetrics People’s Hospital Peking University

To the editor:Aggressive angiomyxoma(AA)is a very rare soft tissue tumor which affects mainly the soft tissues of the pelvis and perineum in *** a slow-growing mesenchymal neoplasm,AA tends to infiltrate locally and recur.1 Here we reported a case of AA of the *** patient was a 36-year-old woman,who presented with a 10 cm×5 cm×5 cm myxoid,well-circumscribed,rubbery mass arising within the vaginal wall and extending to the *** a routine clinical work-up,further examinations including ultrasonography and computed tomography(CT)were performed before the operation to evaluate the extent of the disease and reveal the location,relationship

关键词： FEMALE PELVIS perineum

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Congenital median raphe cysts: Coexistence of cystic lesions and canal-like lesions

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Open Journal of Pediatrics 2013年第3期3卷 274-275页

作者： Masataka Takahashi Toshihiko Watanabe Kaori Sato Michinobu Ohno Koji Yamada Toshiko Takezoe Yasushi Fuchimoto Hajime Ohkita Kentaro Matsuoka Yutaka Kanamori Division of Pathology Department of Pathology National Center for Child Health and Development Tokyo Japan Division of Surgery Department of Surgical Specialties National Center for Child Health and Development Tokyo Japan

Median raphe cyst of the perineum is a rare congenital anomaly and was first reported in 1895. We report a 9-year-old male with median raphe cysts in the perineum which had become swollen and then spontaneously ruptured several times since he was 3 years old. There were two separate lesions;one was a cystic lesion and the other was a canal-like lesion. They were completely excised and the inner layer of the cysts was composed of transitional epithelium.

关键词： Median Raphe Cyst perineum Transitional Epithelium

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