TL;DR: The incidence of anorectal complications following vaginal delivery was studied in 20,500 women and surgical correction of these complications resulted in satisfactory outcome.
Abstract: The incidence of anorectal complications following vaginal delivery was studied in 20,500 women. One thousand forty (5 percent) of all normal vaginal deliveries resulted in episiotomy with third- and fourth-degree extension or a fourth-degree perineal tear. Of these fourth-degree lacerations, 101 patients (10 percent) experienced wound disruption after primary repair. Sixty-seven patients (66 percent) experienced wound disruption that required surgical correction. Anorectal complications were anal ulcer, anorectal abscess, sphincteric disruption, and rectovaginal fistula. Surgical correction of these complications resulted in satisfactory outcome.
TL;DR: A pharmaceutical composition contains a nitric oxide donor and advantageously an optional corticosteroid and/or topical anesthetic as discussed by the authors, which is useful in a method for treating anal disorders such as anal fissure, anal ulcer, hemorrhoidal disease, levator spasm, and so forth.
Abstract: A pharmaceutical composition contains a nitric oxide donor and advantageously an optional corticosteroid and/or topical anesthetic. The composition is useful in a method for treating anal disorders such as anal fissure, anal ulcer, hemorrhoidal disease, levator spasm, and so forth, by topical application to or proximate the affected area.
TL;DR: Nicorandil is a vasodilator used to control angina and has been associated with oral and anal ulceration that resolves upon withdrawal of the drug.
Abstract: Objective Nicorandil is a vasodilator used to control angina. It has been associated with oral and anal ulceration that resolves upon withdrawal of the drug.
Patients and methods We report a series of 13 patients with nonspecific anal ulceration all of whom were receiving nicorandil for control of symptoms of ischaemic heart disease.
Results All the ulcers had similar clinical and histological appearances. All the ulcers healed on withdrawal of the drug.
Conclusion Nicorandil-associated anal ulceration shouldbe considered in the differential diagnoses of nonhealing anal ulcers.
TL;DR: Perianal fistulas cause significant morbidity and diminish atients’ quality of life and can be complicated by the development of fibrotic strictures, perforation, abscess formation, and fisulization in patients with Crohn’s disease.
TL;DR: The findings suggest that the prevalence of anorectal sepsis in homosexual men is high and that symptomatic HIV infection is an important determinant of progress after surgery.
Abstract: This retrospective study details the findings and outcome in 34 homosexual men, out of a total of 177 patients, who underwent surgery for non-condylomatous perianal disease over a 2-year period. Of 34 homosexuals 20 presented with anorectal sepsis compared with 11 of 79 heterosexual male patients (X2 = 24.07, P less than 0.001). Lesions included chronic intersphincteric abscess (eight patients), anal fistula (seven patients) and chronic intersphincteric abscess and fistula (five patients). Anal fissure occurred in 15 patients, anal ulcer in three, skin tags in six, haemorrhoids in two and Kaposi's sarcoma in one. Eight patients were human immunodeficiency virus (HIV) antibody negative, four were asymptomatic HIV antibody positive, 12 had symptomatic HIV infection using the Centers for Disease Control classification and in ten patients HIV status was unknown. Irrespective of the type of surgery performed, healing occurred within 6 weeks of operation in all HIV antibody negative patients, all asymptomatic HIV antibody positive and in only one of nine patients with symptomatic HIV infection. Eight of nine patients with symptomatic HIV infection failed to heal by this time (X2 = 8.98, P less than 0.05). These findings suggest that the prevalence of anorectal sepsis in homosexual men is high and that symptomatic HIV infection is an important determinant of progress after surgery.