Laparoscopic Surgery for Pelvic Support Defects John R
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The Subperitoneal Space and Peritoneal Cavity: Basic Concepts Harpreet K
ª The Author(s) 2015. This article is published with Abdom Imaging (2015) 40:2710–2722 Abdominal open access at Springerlink.com DOI: 10.1007/s00261-015-0429-5 Published online: 26 May 2015 Imaging The subperitoneal space and peritoneal cavity: basic concepts Harpreet K. Pannu,1 Michael Oliphant2 1Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA 2Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, NC, USA Abstract The peritoneum is analogous to the pleura which has a visceral layer covering lung and a parietal layer lining the The subperitoneal space and peritoneal cavity are two thoracic cavity. Similar to the pleural cavity, the peri- mutually exclusive spaces that are separated by the toneal cavity is visualized on imaging if it is abnormally peritoneum. Each is a single continuous space with in- distended by fluid, gas, or masses. terconnected regions. Disease can spread either within the subperitoneal space or within the peritoneal cavity to Location of the abdominal and pelvic organs distant sites in the abdomen and pelvis via these inter- connecting pathways. Disease can also cross the peri- There are two spaces in the abdomen and pelvis, the toneum to spread from the subperitoneal space to the peritoneal cavity (a potential space) and the subperi- peritoneal cavity or vice versa. toneal space, and these are separated by the peritoneum (Fig. 1). Regardless of the complexity of development in Key words: Subperitoneal space—Peritoneal the embryo, the subperitoneal space and the peritoneal cavity—Anatomy cavity remain separated from each other, and each re- mains a single continuous space (Figs. -
Physiology of Female Sexual Function and Dysfunction
International Journal of Impotence Research (2005) 17, S44–S51 & 2005 Nature Publishing Group All rights reserved 0955-9930/05 $30.00 www.nature.com/ijir Physiology of female sexual function and dysfunction JR Berman1* 1Director Female Urology and Female Sexual Medicine, Rodeo Drive Women’s Health Center, Beverly Hills, California, USA Female sexual dysfunction is age-related, progressive, and highly prevalent, affecting 30–50% of American women. While there are emotional and relational elements to female sexual function and response, female sexual dysfunction can occur secondary to medical problems and have an organic basis. This paper addresses anatomy and physiology of normal female sexual function as well as the pathophysiology of female sexual dysfunction. Although the female sexual response is inherently difficult to evaluate in the clinical setting, a variety of instruments have been developed for assessing subjective measures of sexual arousal and function. Objective measurements used in conjunction with the subjective assessment help diagnose potential physiologic/organic abnormal- ities. Therapeutic options for the treatment of female sexual dysfunction, including hormonal, and pharmacological, are also addressed. International Journal of Impotence Research (2005) 17, S44–S51. doi:10.1038/sj.ijir.3901428 Keywords: female sexual dysfunction; anatomy; physiology; pathophysiology; evaluation; treatment Incidence of female sexual dysfunction updated the definitions and classifications based upon current research and clinical practice. -
A Simplified Fascial Model of Pelvic Anatomical Surgery: Going Beyond
Anatomical Science International https://doi.org/10.1007/s12565-020-00553-z ORIGINAL ARTICLE A simplifed fascial model of pelvic anatomical surgery: going beyond parametrium‑centered surgical anatomy Stefano Cosma1 · Domenico Ferraioli2 · Marco Mitidieri3 · Marcello Ceccaroni4 · Paolo Zola5 · Leonardo Micheletti1 · Chiara Benedetto1 Received: 13 March 2020 / Accepted: 5 June 2020 © The Author(s) 2020 Abstract The classical surgical anatomy of the female pelvis is limited by its gynecological oncological focus on the parametrium and burdened by its modeling based on personal techniques of diferent surgeons. However, surgical treatment of pelvic diseases, spreading beyond the anatomical area of origin, requires extra-regional procedures and a thorough pelvic anatomical knowl- edge. This study evaluated the feasibility of a comprehensive and simplifed model of pelvic retroperitoneal compartmen- talization, based on anatomical rather than surgical anatomical structures. Such a model aims at providing an easier, holistic approach useful for clinical, surgical and educational purposes. Six fresh-frozen female pelves were macroscopically and systematically dissected. Three superfcial structures, i.e., the obliterated umbilical artery, the ureter and the sacrouterine ligament, were identifed as the landmarks of 3 deeper fascial-ligamentous structures, i.e., the umbilicovesical fascia, the urogenital-hypogastric fascia and the sacropubic ligament. The retroperitoneal areolar tissue was then gently teased away, exposing the compartments delimited by these deep fascial structures. Four compartments were identifed as a result of the intrapelvic development of the umbilicovesical fascia along the obliterated umbilical artery, the urogenital-hypogastric fascia along the mesoureter and the sacropubic ligaments. The retroperitoneal compartments were named: parietal, laterally to the umbilicovesical fascia; vascular, between the two fasciae; neural, medially to the urogenital-hypogastric fascia and visceral between the sacropubic ligaments. -
A New Anatomic and Staging-Oriented Classification Of
cancers Perspective A New Anatomic and Staging-Oriented Classification of Radical Hysterectomy Mustafa Zelal Muallem Department of Gynecology with Center for Oncological Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Virchow Campus Clinic, Charité Medical University, 13353 Berlin, Germany; [email protected]; Tel.: +49-30-450-664373; Fax: +49-30-450-564900 Simple Summary: The main deficits of the available classifications of radical hysterectomy are the facts that they are based only on the lateral extension of resection, do not depend on the precise anatomy of parametrium and paracolpium and do not correlate with the tumour stage, size or infiltration in the vagina. This new suggested classification depends on the 3-dimentional concept of parametrium and paracolpium and the comprehensive description of the anatomy of parametrium, paracolpium and the pelvic autonomic nerve system. Each type in this classification tailored to the tumour stage according to FIGO- classification from 2018, taking into account the tumour size, localization and infiltration in the vaginal vault, which may make it the most suitable tool for planning and tailoring the surgery of radical hysterectomy. Abstract: The current understanding of radical hysterectomy more is centered on the uterus and little is being discussed about the resection of the vaginal cuff and the paracolpium as an essential part of this procedure. This is because that the current classifications of radical hysterectomy are based only on the lateral extent of resection. This way is easier to be understood but does not reflect Citation: Muallem, M.Z. -
A Vaginal Fornix Foreign Body in a Bitch: a Case Report
Veterinarni Medicina, 59, 2014 (9): 457–460 Case Report A vaginal fornix foreign body in a bitch: a case report M. Fabbi, S. Manfredi, F. Di Ianni, C. Bresciani, A.M. Cantoni, G. Gnudi, E. Bigliardi Department of Veterinary Medical Sciences, University of Parma, Parma, Italy ABSTRACT: A six-year-old intact female Lagotto Romagnolo was referred with a two-day history of purulent vulvar discharge associated with fever, lethargy, polyuria, polydipsia and signs of abdominal pain. Abdominal ultra- sound revealed a grass awn foreign body in the vaginal fornix. Culture swabs obtained from the vagina revealed the presence of Staphylococcus epidermidis as the preponderant organism. Ovariohysterectomy was performed, and the presence of the grass awn was confirmed. A chronic-active vaginitis was found at histological examina- tion. The dog recovered with resolution of all clinical signs. Differential diagnoses for acute vulvar discharge in bitches should include retention of vaginal foreign bodies. To the authors’ knowledge, this is the first reported case of a grass awn foreign body in the vaginal fornix of a dog. Keywords: grass awn; vagina; ultrasound; dog Vaginal foreign bodies are rare in dogs and cats. history of vulvar discharge, lethargy, polyuria and To our knowledge, only six reports have been pub- polydipsia and signs of abdominal pain. General lished in dogs (Ratcliffe 1971; Dietrich 1979; Jacobs examination revealed hyperthermia (39.3 °C), a et al. 1989; McCabe and Steffey 2004; Snead et al. purulent foul-smelling vulvar discharge and pelvic 2010; Gatel et al. 2014), and three in cats (Cordery limb weakness. The last proestrus occurred 30 days 1997; Nicastro and Walshaw 2007; Gatel et al. -
PE2260 Five-Finger Exercise
The Five-Finger Exercise The 5-finger exercise is helpful for relaxation and calming your system. It does not take long, but can help you feel much more peaceful and relaxed and help you feel better about yourself. Try it any time you feel tension. What are the steps to the 5-finger exercise? On one hand, touch your thumb to your index finger. Think back to a time you felt tired after exercise or some other fun physical activity. Touch your thumb to your middle finger. Go back to a time when you had a loving experience. You might recall a loving day with your family or a good friend, a warm hug from a parent or a time you had a really good conversation with someone. Touch your thumb to your ring finger. Remember the nicest compliment anyone ever gave you. Try to accept it now fully. When you do this, you are showing respect for the person who said it. You are really paying them a compliment in return. Touch your thumb to your little finger. Go back in your mind to the most beautiful and relaxing place you have ever been. Spend some time thinking of being there. To Learn More Free Interpreter Services • Adolescent Medicine • In the hospital, ask your nurse. 206-987-2028 • From outside the hospital, call the toll-free Family Interpreting Line, • Ask your healthcare provider 1-866-583-1527. Tell the interpreter • seattlechildrens.org the name or extension you need. Seattle Children’s offers interpreter services for Deaf, hard of hearing or non-English speaking patients, family members and legal representatives free of charge. -
Masturbation
MASTURBATION Curriculum for Excellence Links to health and wellbeing outcomes for Relationships, Sexual Health and Parenthood I am aware of my growing body and I am learning the correct names for its different parts and how they work. HWB 0-47b HWB 1-47b I understand my own body's uniqueness, my developing sexuality, and that of others. HWB 3-47a HWB 4-47a Introduction Masturbation can seem a daunting subject to teach, but it is very important for young people to learn about appropriate touch. School provides an ideal learning environment for this, alongside an opportunity to work alongside parents to tackle this issue. If young people do not learn about masturbation and appropriate touch when they are teenagers, they are in danger of displaying inappropriate behaviour as an adult, often in public, which can lead to more serious repercussions. Staff may worry that teaching about masturbation can provoke a sudden obsession with genitalia, but this is usually a temporary reaction and one which can be successfully dealt with by one-to-one work through Social Stories. Having a policy on Managing Sexualised Behaviour may also be beneficial, outlining an approach to inappropriate touching in the classroom. TOUCHING OURSELVES You will need 2 body outlines/ Bodyboards (male and female). Recap on names of Parts Of The Body. Ask the students which are PRIVATE BODY parts (those covered by underwear- breasts, penis, vagina, anus, clitoris etc.) Tell the group ‘’these are Private Body Parts, not for everyone to touch and see. But sometimes people like to touch their own private body parts to make themselves feel nice and sexy. -
Female Pelvic Relaxation
FEMALE PELVIC RELAXATION A Primer for Women with Pelvic Organ Prolapse Written by: ANDREW SIEGEL, M.D. An educational service provided by: BERGEN UROLOGICAL ASSOCIATES N.J. CENTER FOR PROSTATE CANCER & UROLOGY Andrew Siegel, M.D. • Martin Goldstein, M.D. Vincent Lanteri, M.D. • Michael Esposito, M.D. • Mutahar Ahmed, M.D. Gregory Lovallo, M.D. • Thomas Christiano, M.D. 255 Spring Valley Avenue Maywood, N.J. 07607 www.bergenurological.com www.roboticurology.com Table of Contents INTRODUCTION .................................................................1 WHY A UROLOGIST? ..........................................................2 PELVIC ANATOMY ..............................................................4 PROLAPSE URETHRA ....................................................................7 BLADDER .....................................................................7 RECTUM ......................................................................8 PERINEUM ..................................................................9 SMALL INTESTINE .....................................................9 VAGINAL VAULT .......................................................10 UTERUS .....................................................................11 EVALUATION OF PROLAPSE ............................................11 SURGICAL REPAIR OF PELVIC PROLAPSE .....................15 STRESS INCONTINENCE .........................................16 CYSTOCELE ..............................................................18 RECTOCELE/PERINEAL LAXITY .............................19 -
The Mythical G-Spot: Past, Present and Future by Dr
Global Journal of Medical research: E Gynecology and Obstetrics Volume 14 Issue 2 Version 1.0 Year 2014 Type: Double Blind Peer Reviewed International Research Journal Publisher: Global Journals Inc. (USA) Online ISSN: 2249-4618 & Print ISSN: 0975-5888 The Mythical G-Spot: Past, Present and Future By Dr. Franklin J. Espitia De La Hoz & Dra. Lilian Orozco Santiago Universidad Militar Nueva Granada, Colombia Summary- The so-called point Gräfenberg popularly known as "G-spot" corresponds to a vaginal area 1-2 cm wide, behind the pubis in intimate relationship with the anterior vaginal wall and around the urethra (complex clitoral) that when the woman is aroused becomes more sensitive than the rest of the vagina. Some women report that it is an erogenous area which, once stimulated, can lead to strong sexual arousal, intense orgasms and female ejaculation. Although the G-spot has been studied since the 40s, disagreement persists regarding the translation, localization and its existence as a distinct structure. Objective: Understand the operation and establish the anatomical points where the point G from embryology to adulthood. Methodology: A literature search in the electronic databases PubMed, Ovid, Elsevier, Interscience, EBSCO, Scopus, SciELO was performed. Results: descriptive articles and observational studies were reviewed which showed a significant number of patients. Conclusion: Sexual pleasure is a right we all have, and women must find a way to feel or experience orgasm as a possible experience of their sexuality, which necessitates effective stimulation. Keywords: G Spot; vaginal anatomy; clitoris; skene’s glands. GJMR-E Classification : NLMC Code: WP 250 TheMythicalG-SpotPastPresentandFuture Strictly as per the compliance and regulations of: © 2014. -
Mallet Finger Advice Information for Patients Page 2 This Information Leaflet Is for People Who Have Had a Mallet Finger Injury
Oxford University Hospitals NHS Trust Emergency Department Mallet finger advice Information for patients page 2 This information leaflet is for people who have had a mallet finger injury. It describes the injury, symptoms and treatment. What is a mallet finger? A mallet finger is where the end joint of the finger bends towards the palm and cannot be straightened. This is usually caused by an injury to the end of the finger which has torn the tendon that straightens the finger. Sometimes a flake of bone may have been pulled off from where the tendon should be attached to the end bone. An X-ray will show whether this has happened. In either case, without the use of this tendon the end of your finger will remain bent. What are the symptoms? • pain • swelling • inability to straighten the tip of your finger. page 3 How is it treated? Your finger will be placed in a plastic splint to keep it straight. The end joint will be slightly over extended (bent backwards). The splint must be worn both day and night for 6 to 8 weeks. This allows the two ends of the torn tendon or bone to stay together and heal. The splint will be taped on, allowing you to bend the middle joint of your finger. The splint should only be removed for cleaning (see below). Although you can still use your finger, you should keep your hand elevated (raised) in a sling for most of the time, until the doctor sees you in the outpatient clinic. This will help to reduce any swelling and pain. -
Palm Reading
Palm Reading Also known as palmistry or chiromancy, palm reading is practiced all over the world with roots in Indian astrology and gypsy fortune-telling. The objective is to evaluate a person’s character and aspects of their life by studying the palm of their hand. There is no substantiate evidence of correlation between palm features and psychological traits; palm reading is for entertainment purposes. Getting Started Which hand to read? There are two main practices: For males, the left hand is what you’re born with, and the right is what you’ve accumulated throughout your life. For females, it’s the opposite. Your dominant hand (the hand you use most often) determines your future and your other, non-dominant hand, is used to determine the past or hidden traits Take these into consideration when choosing which hand to read. Reading the Primary Lines of your Hand 1. Interpret the Heart Line This line is believed to indicate emotional stability, romantic perspectives, depression, and cardiac health. Begins below the index finger = content with love life Begins below the middle finger = selfish when it comes to love Begins in-between the middle and index fingers = caring and understanding Is straight and short = less interest in romance Touches life line = heart is broken easily Is long and curvy = freely expresses emotions and feelings Is straight and parallel to the head line = good handle on emotions Is wavy = many relationships, absence of serious relationships Circle on the line = sad or depressed Broken line = emotional trauma 2. Examine the Head Line This line represents learning style, communication style, intellectualism, and thirst for knowledge. -
Understanding the Anatomy of the Denonvilliers Fascia: Review Article Compreendendo a Anatomia Da Fáscia De Denonvilliers: Artigo De Revisão Mohammed Yousef Alessa1
THIEME Review Article 193 Understanding the Anatomy of the Denonvilliers Fascia: Review Article Compreendendo a anatomia da fáscia de Denonvilliers: Artigo de revisão Mohammed Yousef Alessa1 1 King Faisal University Surgery, Hofuf, Eastern Province, Saudi Arabia Address for correspondence Mohammed Yousef Alessa, King Faisal University Surgery, Hofuf, Eastern Provience, Saudi Arabia J Coloproctol 2021;41(2):193–197. (e-mail: [email protected]). Abstract The postoperative outcome of rectal cancer has been improved after the introduction of the principles of total mesorectal excision (TME). Total mesorectal excision includes resection of the diseased rectum and mesorectum with non-violated mesorectal fascia (en bloc resection). Dissection along the mesorectal fascia through the principle of the “holy plane” minimizes injury of the autonomic nerves and increases the chance of preserving them. It is important to stick to the TME principle to avoid perforating the tumor; violating the mesorectal fascia, thus resulting in positive circumferential resectionmargin(CRM);orcausinginjuryto the autonomic nerves, especially if the tumor is located anteriorly. Therefore, identifying the anterior plane of dissection during TME is important because it is related with the autonomic nerves (Denonvilliers Keywords fascia). Although there are many articles about the Denonvilliers fascia (DVF) or the ► anatomy of anterior dissection plane, unfortunately, there is no consensus on its embryological denonvilliers fascia origin, histology, and gross anatomy. In the present review article, I aim to delineate ► understanding and describe the anatomy of the DVF in more details based on a review of the literature, anatomy in order to provide insight for colorectal surgeons to better understand this anatomical ► review article feature and to provide the best care to their patients.