Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0021933 (intussusception)
 3,822 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The descending perineum syndrome, described in 1970 by Alan Parks, remains difficult to interpret clinically and pathophysiologically. A general review of descending perineum was conducted, based on review of the literature published between 1966 and 2004, and retrospective analysis of 1,023 colpocystograms. The symptoms observed are usually secondary to associated lesions. Radiological signs of descending perineum are not always associated with clinical symptoms. Colpocystogram shows perineal descent and associated disorders of anterior and middle pelvic tone, while defecography provides a better explanation for dyschezia which is generally due to an associated posterior disorder (rectocele with rectal intussusception). The management of descending perineum is based on medical treatment and retraining. No consensus has been reached concerning surgical management. Surgery is generally used to treat associated lesions. In the case of complete collapse of perineum, an abdominal approach with infravesical, prerectal and retrorectal tension-free tape to the sacrum could be useful, while transanal staple repair of the rectum could be proposed when descending perineum is associated with only rectal intussusception or rectocele.
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PMID:[Descending perineum in women]. 1599 5

Physiopathological and clinical interpretation of the descending perineum as described by A. Parks in 1970 remains difficult. This review is based on the literature between 1966 and 2004. The observed symptoms are more often due to associated lesions. The descending perineum on X-ray is not always symptomatic. Colpocystography shows the descent of the perineum and pelvic disorders from the anterior and middle parts of the perineum whereas defecography seems to provide a better diagnosis of dyschesia due to posterior damage (such as rectocele or endo-anal intussusception). The first step of treatment is reeducation and medical treatment because there is no consensus for surgical therapy. Soft sacrocolpopexy by the abdominal approach with three meshes, one under the bladder, one in front of and one behind the rectum can be proposed for complete descending perineum. Transanal rectal resection by staple could be useful when the descending perineum is only associated with a rectocele and/or an intra-anal intussusception.
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PMID:[Descending perineum in women]. 1680 91