Evaluation of anatomical and functional aspects of the anal canal in women with vaginal birth and symptoms of fecal incontinence

Detalhes bibliográficos
Autor(a) principal: Iris Daiana Dealcanfreitas
Data de Publicação: 2016
Tipo de documento: Dissertação
Idioma: por
Título da fonte: Biblioteca Digital de Teses e Dissertações da UFC
Texto Completo: http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=17468
Resumo: Faecal incontinence (FI) affects up to 24% of the female population and has a significant impact on quality of life. Different risk categories for the FI have been described. Women with previous vaginal delivery make up the majority of affected individuals. Proper evaluation of this condition, including use of FI scores and functional and anatomical measurements plays a key role in patient management. The study proposes to evaluate anatomical and functional measures of the anal sphincter using three-dimensional ultrasonography (3D US) and anorectal manometry (ARM) in incontinent women with vaginal delivery, to correlate the findings with symptoms of FI and to evaluate the effect of vaginal delivery of anatomy and function of the anal canal. Women with symptoms of FI and vaginal delivery were evaluated with Wexner incontinence score, ARM and 3D US. A control group of asymptomatic nulliparous was included. Resting and contraction pressure, the radial angle of the defect and the length of the external anal sphincter (EAS), the internal anal sphincter (IAS) anterior and posterior, the subsequent EAE + puborectalis muscle (PR) and gap were measured and correlated with scores. Of the 62 women, 49 showed symptoms of FI and 13 were nulliparous asymptomatic. Twenty-five had EAE defects, 8 had combined defect EAS and IAS, 16 had intact sphincters and continence scores were similar. Individuals with sphincter defects had lesser EAS and IAS anterior compared to women without defects. Those with a vaginal birth had less anterior EAS intact compared to nulliparous women. It revealed a correlation between resting pressure and the measure of EAS earlier and IAS in patients with sphincter defects. FI symptoms did not correlate with anal pressure and changes in the anal sphincter. Women with vaginal delivery have less anterior EAS and gap bigger and there were correlations of these with lower resting pressure
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spelling info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisEvaluation of anatomical and functional aspects of the anal canal in women with vaginal birth and symptoms of fecal incontinenceAvaliaÃÃo dos aspectos anatÃmicos e funcionais do canal anal em mulheres com parto vaginal e sintomas de incontinÃncia fecal2016-04-25Sthela Maria Murad Regadas45285918391http://buscatextual.cnpq.br/buscatextual/visualizacv.jsp?id=K4180206Z9Charles Jean Gomes de Mesquita35286504353Lusmar Veras Rodrigues05910803387http://lattes.cnpq.br/829702187108973485074705304http://lattes.cnpq.br/2139751067352674Iris Daiana DealcanfreitasUniversidade Federal do CearÃPrograma de PÃs-GraduaÃÃo em CirurgiaUFCBRCIRURGIAFaecal incontinence (FI) affects up to 24% of the female population and has a significant impact on quality of life. Different risk categories for the FI have been described. Women with previous vaginal delivery make up the majority of affected individuals. Proper evaluation of this condition, including use of FI scores and functional and anatomical measurements plays a key role in patient management. The study proposes to evaluate anatomical and functional measures of the anal sphincter using three-dimensional ultrasonography (3D US) and anorectal manometry (ARM) in incontinent women with vaginal delivery, to correlate the findings with symptoms of FI and to evaluate the effect of vaginal delivery of anatomy and function of the anal canal. Women with symptoms of FI and vaginal delivery were evaluated with Wexner incontinence score, ARM and 3D US. A control group of asymptomatic nulliparous was included. Resting and contraction pressure, the radial angle of the defect and the length of the external anal sphincter (EAS), the internal anal sphincter (IAS) anterior and posterior, the subsequent EAE + puborectalis muscle (PR) and gap were measured and correlated with scores. Of the 62 women, 49 showed symptoms of FI and 13 were nulliparous asymptomatic. Twenty-five had EAE defects, 8 had combined defect EAS and IAS, 16 had intact sphincters and continence scores were similar. Individuals with sphincter defects had lesser EAS and IAS anterior compared to women without defects. Those with a vaginal birth had less anterior EAS intact compared to nulliparous women. It revealed a correlation between resting pressure and the measure of EAS earlier and IAS in patients with sphincter defects. FI symptoms did not correlate with anal pressure and changes in the anal sphincter. Women with vaginal delivery have less anterior EAS and gap bigger and there were correlations of these with lower resting pressureA incontinÃncia fecal (IF) afeta atà 24% da populaÃÃo feminina e tem um impacto significativo na qualidade de vida. Diferentes categorias de risco para a IF jà foram descritas. As mulheres com parto vaginal prÃvio compÃem a maioria dos indivÃduos afetados. A avaliaÃÃo adequada desta condiÃÃo, incluindo uso de escores de IF e medidas funcionais e anatÃmicas desempenha um papel fundamental no manejo do paciente. O estudo busca avaliar medidas anatÃmicas e funcionais do esfÃncter anal usando ultrassonografia tridimensional (US-3D) e manometria anorretal (MAR) em mulheres incontinentes com parto vaginal, correlacionar os achados com sintomas de IF e avaliar o efeito do parto vaginal sobre a anatomia e a funÃÃo do canal anal. Mulheres com sintomas de IF e histÃria de parto vaginal foram avaliadas com teste de incontinÃncia de Wexner, MAR e US-3D. Um grupo controle com nulÃparas assintomÃticas foi incluÃdo. A pressÃo de repouso e contraÃÃo, o Ãngulo radial do defeito e o comprimento do esfÃncter anal externo (EAE), o esfÃncter anal interno (EAI) anterior e posterior, o EAE posterior + mÃsculo puborretal (PR) e o gap foram medidos e correlacionados com escores. Das 62 mulheres, 49 apresentaram sintomas de IF e 13 eram nulÃparas assintomÃticas. Vinte e cinco tinham defeitos EAE, em 8 havia defeito combinado EAE e EAI, 16 tinham esfÃncteres intactos e os escores de continÃncia foram semelhantes. IndivÃduos com defeitos do esfÃncter tinham EAE e EAI anterior menores em relaÃÃo Ãs mulheres sem defeitos. Aquelas com um parto vaginal tinham um menor EAE Ãntegro anterior em relaÃÃo Ãs mulheres nulÃparas. Evidenciaram-se correlaÃÃes entre a pressÃo de repouso e a medida de EAE anterior e EAI em pacientes com defeitos do esfÃncter. A anÃlise concluiu que sintomas de IF nÃo se correlacionaram com pressÃes anais e alteraÃÃes do esfÃncter anal. Mulheres com parto vaginal tÃm menor EAE anterior e gap maior, e hà correlaÃÃes destes com menor pressÃo de repouso.http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=17468application/pdfinfo:eu-repo/semantics/openAccessporreponame:Biblioteca Digital de Teses e Dissertações da UFCinstname:Universidade Federal do Cearáinstacron:UFC2019-01-21T11:30:47Zmail@mail.com -
dc.title.en.fl_str_mv Evaluation of anatomical and functional aspects of the anal canal in women with vaginal birth and symptoms of fecal incontinence
dc.title.alternative.pt.fl_str_mv AvaliaÃÃo dos aspectos anatÃmicos e funcionais do canal anal em mulheres com parto vaginal e sintomas de incontinÃncia fecal
title Evaluation of anatomical and functional aspects of the anal canal in women with vaginal birth and symptoms of fecal incontinence
spellingShingle Evaluation of anatomical and functional aspects of the anal canal in women with vaginal birth and symptoms of fecal incontinence
Iris Daiana Dealcanfreitas
CIRURGIA
title_short Evaluation of anatomical and functional aspects of the anal canal in women with vaginal birth and symptoms of fecal incontinence
title_full Evaluation of anatomical and functional aspects of the anal canal in women with vaginal birth and symptoms of fecal incontinence
title_fullStr Evaluation of anatomical and functional aspects of the anal canal in women with vaginal birth and symptoms of fecal incontinence
title_full_unstemmed Evaluation of anatomical and functional aspects of the anal canal in women with vaginal birth and symptoms of fecal incontinence
title_sort Evaluation of anatomical and functional aspects of the anal canal in women with vaginal birth and symptoms of fecal incontinence
author Iris Daiana Dealcanfreitas
author_facet Iris Daiana Dealcanfreitas
author_role author
dc.contributor.advisor1.fl_str_mv Sthela Maria Murad Regadas
dc.contributor.advisor1ID.fl_str_mv 45285918391
dc.contributor.advisor1Lattes.fl_str_mv http://buscatextual.cnpq.br/buscatextual/visualizacv.jsp?id=K4180206Z9
dc.contributor.referee1.fl_str_mv Charles Jean Gomes de Mesquita
dc.contributor.referee1ID.fl_str_mv 35286504353
dc.contributor.referee2.fl_str_mv Lusmar Veras Rodrigues
dc.contributor.referee2ID.fl_str_mv 05910803387
dc.contributor.referee2Lattes.fl_str_mv http://lattes.cnpq.br/8297021871089734
dc.contributor.authorID.fl_str_mv 85074705304
dc.contributor.authorLattes.fl_str_mv http://lattes.cnpq.br/2139751067352674
dc.contributor.author.fl_str_mv Iris Daiana Dealcanfreitas
contributor_str_mv Sthela Maria Murad Regadas
Charles Jean Gomes de Mesquita
Lusmar Veras Rodrigues
dc.subject.cnpq.fl_str_mv CIRURGIA
topic CIRURGIA
dc.description.abstract.por.fl_txt_mv Faecal incontinence (FI) affects up to 24% of the female population and has a significant impact on quality of life. Different risk categories for the FI have been described. Women with previous vaginal delivery make up the majority of affected individuals. Proper evaluation of this condition, including use of FI scores and functional and anatomical measurements plays a key role in patient management. The study proposes to evaluate anatomical and functional measures of the anal sphincter using three-dimensional ultrasonography (3D US) and anorectal manometry (ARM) in incontinent women with vaginal delivery, to correlate the findings with symptoms of FI and to evaluate the effect of vaginal delivery of anatomy and function of the anal canal. Women with symptoms of FI and vaginal delivery were evaluated with Wexner incontinence score, ARM and 3D US. A control group of asymptomatic nulliparous was included. Resting and contraction pressure, the radial angle of the defect and the length of the external anal sphincter (EAS), the internal anal sphincter (IAS) anterior and posterior, the subsequent EAE + puborectalis muscle (PR) and gap were measured and correlated with scores. Of the 62 women, 49 showed symptoms of FI and 13 were nulliparous asymptomatic. Twenty-five had EAE defects, 8 had combined defect EAS and IAS, 16 had intact sphincters and continence scores were similar. Individuals with sphincter defects had lesser EAS and IAS anterior compared to women without defects. Those with a vaginal birth had less anterior EAS intact compared to nulliparous women. It revealed a correlation between resting pressure and the measure of EAS earlier and IAS in patients with sphincter defects. FI symptoms did not correlate with anal pressure and changes in the anal sphincter. Women with vaginal delivery have less anterior EAS and gap bigger and there were correlations of these with lower resting pressure
A incontinÃncia fecal (IF) afeta atà 24% da populaÃÃo feminina e tem um impacto significativo na qualidade de vida. Diferentes categorias de risco para a IF jà foram descritas. As mulheres com parto vaginal prÃvio compÃem a maioria dos indivÃduos afetados. A avaliaÃÃo adequada desta condiÃÃo, incluindo uso de escores de IF e medidas funcionais e anatÃmicas desempenha um papel fundamental no manejo do paciente. O estudo busca avaliar medidas anatÃmicas e funcionais do esfÃncter anal usando ultrassonografia tridimensional (US-3D) e manometria anorretal (MAR) em mulheres incontinentes com parto vaginal, correlacionar os achados com sintomas de IF e avaliar o efeito do parto vaginal sobre a anatomia e a funÃÃo do canal anal. Mulheres com sintomas de IF e histÃria de parto vaginal foram avaliadas com teste de incontinÃncia de Wexner, MAR e US-3D. Um grupo controle com nulÃparas assintomÃticas foi incluÃdo. A pressÃo de repouso e contraÃÃo, o Ãngulo radial do defeito e o comprimento do esfÃncter anal externo (EAE), o esfÃncter anal interno (EAI) anterior e posterior, o EAE posterior + mÃsculo puborretal (PR) e o gap foram medidos e correlacionados com escores. Das 62 mulheres, 49 apresentaram sintomas de IF e 13 eram nulÃparas assintomÃticas. Vinte e cinco tinham defeitos EAE, em 8 havia defeito combinado EAE e EAI, 16 tinham esfÃncteres intactos e os escores de continÃncia foram semelhantes. IndivÃduos com defeitos do esfÃncter tinham EAE e EAI anterior menores em relaÃÃo Ãs mulheres sem defeitos. Aquelas com um parto vaginal tinham um menor EAE Ãntegro anterior em relaÃÃo Ãs mulheres nulÃparas. Evidenciaram-se correlaÃÃes entre a pressÃo de repouso e a medida de EAE anterior e EAI em pacientes com defeitos do esfÃncter. A anÃlise concluiu que sintomas de IF nÃo se correlacionaram com pressÃes anais e alteraÃÃes do esfÃncter anal. Mulheres com parto vaginal tÃm menor EAE anterior e gap maior, e hà correlaÃÃes destes com menor pressÃo de repouso.
description Faecal incontinence (FI) affects up to 24% of the female population and has a significant impact on quality of life. Different risk categories for the FI have been described. Women with previous vaginal delivery make up the majority of affected individuals. Proper evaluation of this condition, including use of FI scores and functional and anatomical measurements plays a key role in patient management. The study proposes to evaluate anatomical and functional measures of the anal sphincter using three-dimensional ultrasonography (3D US) and anorectal manometry (ARM) in incontinent women with vaginal delivery, to correlate the findings with symptoms of FI and to evaluate the effect of vaginal delivery of anatomy and function of the anal canal. Women with symptoms of FI and vaginal delivery were evaluated with Wexner incontinence score, ARM and 3D US. A control group of asymptomatic nulliparous was included. Resting and contraction pressure, the radial angle of the defect and the length of the external anal sphincter (EAS), the internal anal sphincter (IAS) anterior and posterior, the subsequent EAE + puborectalis muscle (PR) and gap were measured and correlated with scores. Of the 62 women, 49 showed symptoms of FI and 13 were nulliparous asymptomatic. Twenty-five had EAE defects, 8 had combined defect EAS and IAS, 16 had intact sphincters and continence scores were similar. Individuals with sphincter defects had lesser EAS and IAS anterior compared to women without defects. Those with a vaginal birth had less anterior EAS intact compared to nulliparous women. It revealed a correlation between resting pressure and the measure of EAS earlier and IAS in patients with sphincter defects. FI symptoms did not correlate with anal pressure and changes in the anal sphincter. Women with vaginal delivery have less anterior EAS and gap bigger and there were correlations of these with lower resting pressure
publishDate 2016
dc.date.issued.fl_str_mv 2016-04-25
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/masterThesis
status_str publishedVersion
format masterThesis
dc.identifier.uri.fl_str_mv http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=17468
url http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=17468
dc.language.iso.fl_str_mv por
language por
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Universidade Federal do CearÃ
dc.publisher.program.fl_str_mv Programa de PÃs-GraduaÃÃo em Cirurgia
dc.publisher.initials.fl_str_mv UFC
dc.publisher.country.fl_str_mv BR
publisher.none.fl_str_mv Universidade Federal do CearÃ
dc.source.none.fl_str_mv reponame:Biblioteca Digital de Teses e Dissertações da UFC
instname:Universidade Federal do Ceará
instacron:UFC
reponame_str Biblioteca Digital de Teses e Dissertações da UFC
collection Biblioteca Digital de Teses e Dissertações da UFC
instname_str Universidade Federal do Ceará
instacron_str UFC
institution UFC
repository.name.fl_str_mv -
repository.mail.fl_str_mv mail@mail.com
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