Mahmoud Adel Abu Alwafa,  <br/><br/>
Evaluation of mesh perineoplasty in cases of perineal descent  syndrome with preoperative assessment of the size of the perineal  body :  A prospective cohort study / 
 تقييم رأب العجان بشبكه في حالات متلازمة هبوط العجان مع تقييم حجم الجسم العجان قبل العمليه :  دراسه مستقبليه 
by Mahmoud Adel Abu Alwafa ; Supervised Prof. Dr. Ali Ahmed Shafik, Dr. Mohamed Yehia Ahmed, Dr. Osama Refaie Mohamed, Dr. Mohamed Tamer Mohamed.  
 - 113 pages :  illustrations ;  25 cm. +   CD. 
<br/><br/>Thesis (Ph.D)-Cairo University, 2025. 
<br/><br/>Bibliography: pages 95 -113.  
<br/><br/> Background: While Current surgeries target rectocele and <br/>intussusception in patients with obstructed defecation syndrome (ODS), <br/>excessive perineal descent may contribute to surgical failure. This study <br/>evaluated the effectiveness of mesh perineoplasty, a procedure designed <br/>to reinforce the perineum, in patients with ODS and abnormal PD. <br/>Methods: Twenty-nine patients (20 females, 9 males; mean age 43.17 ± <br/>10.7 years) with ODS and PD were assessed preoperatively using the <br/>Cleveland Constipation Score (CCS), perineometer, anorectal manometry, <br/>and MRI defecography. All underwent mesh perineoplasty and were <br/>followed up for 6 months. <br/><br/> <br/><br/>Results: Significant improvements were noted postoperatively. The CCS <br/>decreased from 18.0 ± 3.21 to 12.69 ± 4.65 (P < 0.001), intrarectal <br/>pressure increased from 34.34 ± 6.03 mmHg to 41.17 ± 5.85 mmHg (P < <br/>0.001), and mean perineal descent improved from 2.29 ± 0.55 cm to 1.74 <br/>± 0.51 cm (P < 0.001). However, 9 patients (31%) reported persistent <br/>symptoms. All had rectal intussusception, and all symptomatic females <br/>had uterine prolapse with greater descent. They also exhibited smaller <br/>perineal body dimensions, greater PD, and were older than the improved <br/>group (mean age 55.67 vs. 37.55 years; P < 0.001). <br/>Conclusion: Mesh perineoplasty is a promising procedure for patients <br/>with ODS and excessive PD. However, factors intussusception, uterine <br/>prolapse, older age, and smaller perineal body dimensions may predict <br/>poorer outcomes, stressing the need for personalized surgical planning.    متلازمة التبرز الانسدادي هي نوع من الإمساك يتميز ببراز مجزأ، والحاجة إلى الإجهاد عند التبرز، والشعور بعدم اكتمال البراز. يمكن ملاحظة سقوط العجان في 75% إلى 84% من مرضى متلازمة التبرز الانسدادي. لقد افترضنا أن المرض قد يكون مسؤولاً عن فشل معظم العمليات. الهدف من دراستنا هو تقييم النتائج السريرية والمورفولوجية والوظيفية الأولية قصيرة المدى لإجراء جراحي جديد، الدعم العجاني المستعرض (رأب العجان الشبكي) لتصحيح الحالة المرضية لدى مجموعة مختارة من المرضى. 
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<br/><br/><br/>Text in English and abstract in Arabic & English. 
<br/><br/><label>Subjects--Topical Terms: </label><br/>General Surgery<br/>الجراحة العامة
<br/><br/><label>Subjects--Index Terms: </label>Obstructed Defecation Syndrome  Perineal Descent   Mesh  Perineoplasty  Intussusception  Rectocele  Uterine Prolapse  سقوط العجان   انغلاق المستقيم 
<br/><br/><label>Dewey Class. No.: </label>617