Sexual Dysfunction Secondary to Surgical Treatment

Sexual dysfunction following rectal surgery for IBD has been reported in 1-27 of cases but dysfunction is often partial and transient 119, 128, 132, 133, 142-148 . This is usually due to damage of neurological structures during pelvic dissection, although psychogenic or vasculogenic factors may contribute 149 . Normal sexual function in males is under the control of both the sympathetic and parasympathetic system erection is mainly mediated by parasympa-thetic fibres, while sympathetic fibres...

Recto Vaginal Fistula

Colocutaneous Fistula

The development of fistulae is a common complication of Crohn's disease CD . The lifetime risk of fistula development in patients with CD has typically been reported to range from 20 to 40 . The reported incidence of fistulizing CD from referral-based case series ranged from 17 to as much as 85 1-3 . The probability of internal fistulae was particularly high in patients with perianal disease who presented a relative risk of 3.4 compared to patients with different localizations 4 . Over time,...

Anal Skin Tags and Haemorrhoids

Skin Tags After Hemorrhoids

Anal skin tags are typically asymptomatic and present problems only when they interfere with perianal hygiene Fig. 5 . They are more prominent with active intestinal disease. Approximately 25 resolve spontaneously, generally after remission of concomitant bowel disease. These tags should not be removed Fig. 5. Anal tags with ulceration and tissue inflammation Fig. 5. Anal tags with ulceration and tissue inflammation because that may result in an unhealed wound, a chronic ulcer or perianal...

Rectus Abdominis Myocutaneous Flap

Gracilis Myocutaneous Flaps

This technique was described by Taylor et al. in 1983 35 . It is an excellent method for closing a large perineal defect. Based on the inferior epigastric artery and vein, it may be passed into the pelvis to close the pelvic floor and fill the dead space. It is best employed pro-phylactically in high risk patients at the time of proc-tectomy when potential perineal wound problems are anticipated 17 , or at the time of abdominoperineal excision for a large neoplasm 34 when extensive perineal...

Ultrasonographic Assessment of Perianal Crohns Disease

Eas Defect Ultrasound

Accurate identification of all loculate purulent areas and definition of the anatomy of the primary fistulous tract, secondary extensions and internal opening is crucial for the treatment plan. EAUS has been demonstrated to be a very helpful diagnostic tool in accurately assessing all fistula or abscess characteristics 8-11, 16, 17 . Ultrasound examination with the 2050 transducer is generally started using 13 MHz, changing to 12 MHz or 9 MHz to optimise visualisation of the deeper structures...

Irritable Pouch Syndrome IPS

IPS is a functional disorder diagnosed in symptomatic patients who suffer mainly from increased bowel frequency, urgency and abdominal pain without endoscopic or histologic evidence of rectal cuff or pouch inflammation 75 . Clinical features overlap with those of pouchitis and resemble those of irritable bowel syndrome. The aetiology is unclear, and is probably multifactorial in nature. Brain-gut factors may play a role in the pathophysiology of IPS. It is currently a diagnosis of exclusion. A...