Pelviperineology

Pelviperineology

Basic info

  • Publisher: Galenos Publishing House
  • Country of publisher: turkey
  • Date added to EuroPub: 2020/May/12

Subject and more

  • LCC Subject Category: Medicine, Gynecology
  • Publisher's keywords: Medicine, Gynecology
  • Language of fulltext: english
  • Time from submission to publication: weeks

Publication charges

  • Article Processing Charges (APCs): No
  • Submission charges: No
  • Waiver policy for charges? No

Open access & licensing

  • Type of License:
  • License terms
  • Open Access Statement: No
  • Year open access content began: 2007
  • Does the author retain unrestricted copyright? False
  • Does the author retain publishing rights? False

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This journal has '13' articles

Pain mapping: A mechanisms-oriented protocol for the assessment of chronic pelvic pain and urogenital pain syndromes

Pain mapping: A mechanisms-oriented protocol for the assessment of chronic pelvic pain and urogenital pain syndromes

Authors: MAREK JANTOS
Pelviperineology 2020/May/12
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Abstract

Objective: Chronic pelvic pain (CPP) and various pelvic dysfunctions are best assessed by consultants with knowledge and training in myofascial pain. The prevalence of myofascial pain is recognised but what is needed is a validated protocol to guide physical examination of pelvic structures. Pain mapping was developed to assist with localising active and passive sources of pain, evaluating its severity, temporal characteristics, topography and mechanisms and guiding therapy. Materials and Methods: This is a prospective study involving the pain mapping of 320 female volunteers, consisting of women diagnosed with chronic urogenital pain (CUP), and of a comparison and control group. The protocol uses three pain maps to guide assessment of the external urogenital area, internal pelvic floor structures and paraurethral region, and follows an established strategy to maintain consistency. Results: The mean age of the CUP group was 34.7±12.1 years; 31.6±10.1 for the gynaecology comparison group; and 35.5±11.5 for the control group. There were no significant differences in age or parity, the groups were well matched for statistical comparison. The highest pain scores from Map A were noted around the vestibule and urethral meatus; from Map B included all of the internal pelvic structures tested; and from Map C all points were painful and accounted for the highest scores of all the points mapped. Logistic regression analysis identified two points from each of the three maps (a total of six points), that provide 94% accuracy in the diagnosis of chronic urogenital pain syndrome. Conclusion: The pain mapping study demonstrates the benefits of using an established protocol for localising and assessing pelvic pain. The results highlight the role of peripheral mechanisms, in the form of myofascial changes associated with pain and organ dysfunction. The paraurethral area appears to be the primary generator of CUP symptoms and diagnostically is the most reliable in differentiating between CUP cases and asymptomatic controls. As an anatomical region the paraurethral area is an overlooked source of pain and rarely tested during diagnostic assessments.

Keywords: Bladder pain syndrome, chronic pelvic pain, chronic urogenital pain, myofascial pain, pain mapping, vulvodynia
Distinguishing sources of pain: Central vs peripheral mediation

Distinguishing sources of pain: Central vs peripheral mediation

Authors: RICHARD GEVIRTZ
Pelviperineology 2020/May/12
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Abstract

Research in chronic pain often fails to distinguish the pain source: central vs peripheral. In this review, I lay out a case for a greater consideration of a peripheral pain source, namely myofascial trigger points. Findings from our group are presented indicating that trigger points are alpha sympathetically innervated and are not directly related to the cholinergic neuro-muscular system. Treatment implications are discussed.

Keywords: Myofascial pain trigger points; sympathetic muscle innervation
Efficacy of pelvic floor magnetic stimulation combined with electrical stimulation on postpartum pelvic organ prolapse: a retrospective study

Efficacy of pelvic floor magnetic stimulation combined with electrical stimulation on postpartum pelvic organ prolapse: a retrospective study

Authors: LIN ZHANG, XIAO JUAN LV, JIASONG TANG
Pelviperineology 2020/May/12
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Abstract

Objective: To evaluate the effect of pelvic floor magnetic stimulation combined with electrical stimulation on postpartum pelvic organ prolapse. Materials and Methods: A retrospective study was performed by reviewing the clinical records of postpartum patients with pelvic organ prolapse (POP). POP stage, pelvic floor muscle (PFM) strength, and intrapelvic surface electromyography were compared before and after 20 treatment sessions of combined pelvic floor magnetic and electrical stimulation. Results: A total of 90 patients’ data files were analyzed. One-hundred percent (90 of 90) of the patients improved by decreasing one stage of POP; 93.3% (84 of 90) of patients improved their PFM; the amplitudes for phasic, tonic and endurance contraction were all significantly increased. Conclusions: The cocktail scheme combining magnetic stimulation, electrical stimulation and biofeedback, not only increases the awareness of PFM, but also improves the PFM contraction and POP stage.

Keywords: Electrical stimulation; pelvic floor magnetic stimulation; pelvic organ prolapse; postpartum
Introduction to the Fascial Manipulation® model for case reports

Introduction to the Fascial Manipulation® model for case reports

Authors: PAWEŁ MALICKI, JAROSŁAW CIECHOMSKI
Pelviperineology 2020/May/12
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Abstract

The Fascial Manipulation® method is a concept based on fascial anatomy and physiology. Based on research, the biomechanical model for internal dysfunctions offers possibilities for effective treatment of such ailments as: vulvodynia, constipation, urinary incontinence, chronic urogenital pain, painful intercourse, scars post surgical intervention and many more. For a comprehensive outline of FM treatment, it is necessary to take part in a FM course. This introduction is intended as general information for the two case studies that follow.

Keywords: Biomechanical model; catenary; center of coordination (CC); center of fusion (CF); densification; Fascial Manipulation; internal dysfunction
Case report: Treatment of episiotomy scars according to the concept of Fascial Manipulation®

Case report: Treatment of episiotomy scars according to the concept of Fascial Manipulation®

Authors: JAROSŁAW CIECHOMSKI, PAWEŁ MALICKI
Pelviperineology 2020/May/12
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Abstract

The widespread use of episiotomy contributes to pelvic floor muscle dysfunction and concomitant complaints. The biomechanical model of the Fascial Manipulation method addresses the consequences of episotomy. Ailments such as painful intercourse, dysuria, chronic pelvic pain can be successfully treated using the Fascial Manipulation model.

Keywords: Care of the scar tissue; chronic urogenital pain; dysuria; episiotomy; Fascial Manipulation; pelvic sensitization; pudendal nerve neuralgia
Case report: Application of the biomechanical model of Fascial Manipulation® in the case of vulvodynia

Case report: Application of the biomechanical model of Fascial Manipulation® in the case of vulvodynia

Authors: PAWEŁ MALICKI, JAROSŁAW CIECHOMSKI
Pelviperineology 2020/May/12
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Abstract

Vulvodynia is one of the more common pelvic floor dysfunction that women suffer from and affects up to 20% of women and is mostly seen as a dysfunction of the pelvis, lumbar spine and hip joint. It is not enough to base gynecological or physiotherapeutic interview only on the symptoms associated with this region of the body, but even seemingly “unrelated” symptoms such as endocrine dysfunctions or skin alterations, which at first may seem unrelated to physiotherapy, need to be taken in consideration. Vulvodynia is a complex and multidimensional problem requiring a comprehensive approach. The Fascial Manipulation concept is the only physiotherapeutic method giving the possibility of such a global analysis of a patient and focused on the cause of effective treatment. The data collected in detail, combined with the motor and palpation verification, allow the therapy to be planned in detail and with a very good result.

Keywords: Chronic urogenital pain; Fascial Manipulation; pelvic floor dysfunction; vulvodynia
Tethered vagina syndrome

Tethered vagina syndrome

Authors: KLAUS GOESCHEN
Pelviperineology 2020/May/12
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Abstract

The key to understanding the pathogenesis leading to the “Tethered vagina syndrome” and its cure by a skin graft applied to the anterior vaginal wall is to understand the importance of the three oppositely-acting directional forces which close the urethral tube and on relaxation of the forward force, open it for micturition. Any scarring from vaginal excision during “native tissue repair”, application of large mesh sheets, or overstretching by a Burch colposuspension effectively “tethers” the more powerful posterior forces to the weaker anterior force; the posterior urethral wall is pulled open exactly as happens during micturition; the patient loses urine uncontrollably typically on getting out of bed in the morning, which is the classical diagnostic symptom.

Keywords: No Keywords
Non-conventional haemorrhoid symptoms reported by female patients

Non-conventional haemorrhoid symptoms reported by female patients

Authors: JAMES KENT, JACQUES OOSTHUIZEN, CELIA WILKINSON
Pelviperineology 2020/May/12
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Abstract

Objective: This study was undertaken to assess the importance of several non-conventional symptoms, including perianal hygiene, to female patients undergoing haemorrhoidectomy and to correlate these with the presence of associated skin tags. Materials and Methods: A single surgeon retrospective study used a customised questionnaire aimed specifically at female patients undergoing Milligan-Morgan haemorrhoidectomy with excision of significant associated skin tags to assess non-conventional symptoms. Postal surveys were sent to 71 women with 52 replies, three exclusions due to hybrid procedures and 49 patients analysed. Results: Painful prolapse and bleeding were still the most common reasons for undergoing haemorrhoidectomy but perianal hygiene (the ability to keep the area clean after toileting and during the day) was significant in nearly 60% of patients. Itching (40%), concerns about odour (35%), general discomfort (35%) and embarrassment in case their partner saw the haemorrhoids or skin tags was significant in 27%. Conclusion: Haemorrhoidectomy with complete removal of the skin tags resulted in statistically significant improvement in the parameters of odour, pruritis, toileting and less interference with the patients sex life. Surprisingly some aspects of continence were improved. The study shows that non-conventional symptoms are important in female patients and may influence the patients perception of the success of the operation. A simple modification of Golighers’ classification is proposed to reflect the presence of skin tags and to guide assessment of the success of novel treatments for haemorrhoids in women.

Keywords: Haemorrhoids; treatment; hygiene
Chronic pelvic pain and pelvic organ prolapse: a consequence of upright position?

Chronic pelvic pain and pelvic organ prolapse: a consequence of upright position?

Authors: KLAUS GOESCHEN, BERNHARD LIEDL
Pelviperineology 2020/May/12
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Abstract

Objective: The pathogenesis of chronic pelvic pain (CPP) is still incompletely understood. Generally accepted is, that soft tissue structures mutate with age, loose tension and by this can provoke CPP. This raises the question, of whether the bony pelvis underlies comparable age-dependent changes and if so, how this alteration has impact on the static anatomy of the pelvic floor and the suspension and supporting system. Materials and Methods: In order to answer this question we analysed the biological evolution of human beings and checked the historical literature regarding age-dependent static changes of the bony pelvis. Results: The vertical spine position is primarily due to an angulation of the lumbar spine against the sacrum causing a lordotic curve. The upright position of human beings forces the sacrum to curve, age dependent more and more. This leads to a descent of the promontorium causing a lifting of the coccyx and the pubic symphysis. This rotation causes a flatter pelvic floor. Conclusion: The age-dependent, now horizontal positioned pelvic floor provokes an unphysiological stretching on the soft-tissue-pelvic-floor structures causing and boosting a decompensation of the pelvic organ support and suspension system. Overstretched connective tissue, ligaments, nerves and muscles react with pain.

Keywords: Chronic pelvic pain; bony pelvis; upright posture; pelvic organ prolapse; posterior fornix syndrome
Transperineal bilateral sacrospineous colpofixation for the treatment of female genital prolapse – 5-year results

Transperineal bilateral sacrospineous colpofixation for the treatment of female genital prolapse – 5-year results

Authors: FRANZISKA C. HEMPTENMACHER, STEFAN OLLIG, ANDREAS SÜSSE, DIRK G. KIEBACK
Pelviperineology 2020/May/12
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Abstract

Objective: Female genital prolapse is observed with increasing frequency in the era of large aging populations. Various surgical techniques have been established, varying in performance, difficulty and outcome, specifically complications. In order to optimize both aspects, we have developed a refined transperineal bilateral sacrospineous colpofixation technique (TPBCF) and given a detailed, step-by-step description of the technique. Materials and Methods: In a study of 162 patients with vaginal prolapse surgical and functional outcomes of TPBCF have been evaluated with 5-year follow-up. Results: No rectal injury was observed re-intervention for any complications was limited to three erosions with only one requiring resection of 2 cm of tape in the median position followed by successful re-closure. Prolapse correction was found at 5 years to be 61% POPQ 0 and 39% POPQ1. Conclusion: These results were stable when compared with follow-up data at 6 months postoperatively. The authors conclude, that TPBCF is an efficient minimally invasive technique for the treatment of female genital prolapse with a favourable effect/complication ratio.

Keywords: Transperineal bilateral sacrospineous colpofixation; operative therapy; vaginal sling placement; vaginal vault prolapse, surgery, complications, outcome, 5-year results

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