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Levator ani repair by transvaginal approach

  • F. RisEmail author
  • M. Alketbi
  • C. R. Scarpa
  • E. Gialamas
  • A. Balaphas
  • J. Robert-Yap
  • K. Skala
  • G. Zufferey
  • N. C. Buchs
  • B. Roche
Technical Advances

Introduction

Levator ani injury in women is mainly caused by obstetrical damage, but any kind of direct perineal trauma can be also the cause (e.g., pelvic fracture in a road accident). The symptoms of levator ani damage are essentially anal incontinence, dyschezia, pain, colpophony (sound from the vagina at unexpected moments) and/or sexual dysfunction. Indications for a levator ani, mostly a puborectalis repair, are symptomatic damage of the muscle resulting in a retraction and a defect of the levator ani on the damaged side. The damage can be assessed by a simple inspection, with a clear deviation of the anus from the midline, as shown in Fig. 1. By careful vaginal and rectal examination, it is possible to feel the defect. The damage can be confirmed by perineal, endoanal or transvaginal ultrasound and magnetic resonance imaging (MRI).

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedure performed in this studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study

Supplementary material

Supplementary material 1 (MP4 426844 KB)

References

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • F. Ris
    • 1
    Email author
  • M. Alketbi
    • 1
  • C. R. Scarpa
    • 1
  • E. Gialamas
    • 1
  • A. Balaphas
    • 1
  • J. Robert-Yap
    • 1
  • K. Skala
    • 1
  • G. Zufferey
    • 2
  • N. C. Buchs
    • 1
  • B. Roche
    • 1
  1. 1.Proctology Unit, Division of Visceral Surgery, Department of SurgeryGeneva University Hospitals and Medical SchoolGeneva 14Switzerland
  2. 2.Department of SurgeryNyon District General HospitalNyon (GHOL)Switzerland

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