by msimon » 11 Aug 2014, 14:05
Anyone know what this means?
"In addition to the above two factors, it has been pos
-tulated that the pathogenesis of posterior anal fissures is
contributed by the repeated preferential over-stretching
of the posterior anal sphincter complex and perineum
[6,7].This is very likely secondary to the direction of the passage
of faeces due to the anorectal angle. Furthermore there
is a relative paucity of support between the coccyx and
the anorectal ring. This preferential over-stretching of
the posterior perineum need not occur with full perineal
descent. In these cases, any descent is likely to be very
subtle. Many of the patients with posterior anal fissures
actually do not have clinical perineal descent. This syndrome
in turn perpetuates the cycle of anal trauma causing pain
and increased internal sphincter tone which in turn leads
to mucosa ischemia and non-healing fissures. The fissure is
subsequently exposed to trauma again, restarting the whole cycle."
Dec '13 Fissure from anoscope
3 X internal sphincter botox
'08-'15 Botox for pelvic floor dysfunction
Nov '14 LIS/sentinel tag removal
Feb '15 Deroofing of recurrent infection from LIS
summer '15-healed but still ongoing muscle dysfunction/pain