Foreword vii by Robert Kay

Introduction ix

G. Willy Davila

SECTION I Concept of the Pelvic Floor as a Unit

1-1 Concept of the Pelvic Floor as a Unit

G. Willy Davila 3

SECTION II Epidemiology and Prevalence

2-1 Epidemiology of Non-Neurogenic Urinary Dysfunction

Usama M. Khater, Gassan Haddad, and Gamal M. Ghoniem 9

2-2 Bowel Dysfunction

James Doty and Jonathan E. Efron 15

2-3 Genital Prolapse, Urogenital Atrophy, and Sexual Dysfunction

Minda Neimark 19

SECTION III Evaluation


Gamal M. Ghoniem 26

3-1 Primary Evaluation of the Pelvic Floor

Nathan Guerette, Dana R. Sands, and G. Willy Davila 27

3-2 Urodynamics

Gamal M. Ghoniem and Usama M. Khater 35

3-3 Imaging of the Genitourinary Tract in Females

M. Louis Moy and Sandip P. Vasavada 47

3-4 Anorectal Physiology

T. Cristina Sardinha and Dana R. Sands 51

3-5 Anorectal Ultrasound

Juan J. Nogueras 57

3-6 Neurologic Evaluation of the Pelvic Floor

Virgilio Salanga 63

3-7 Upper Gastrointestinal Evaluation Related to the Pelvic Floor

Gregory F. Bonner 67

SECTION IV Anatomic Correlates


G. Willy Davila 70

4-1 Urologic Anatomic Correlates

Jonathan Jay 71

4-2 Genital Anatomic Correlates

Kevin J. Stepp and Matthew D. Barber 79

4-3 Colorectal Anatomic Correlates

James Doty and Eric G. Weiss 89

SECTION V Sexual Function

5-1 Female Sexual Dysfunction

Lawrence S. Hakim and Giovanna M. DaSilva 97

SECTION VI Incontinence Therapy


Steven D. Wexner 108

6-1 Device Therapy for Stress Incontinence

Jennifer T. Pollak and G. Willy Davila 109

6-2 Medications for Stress Urinary Incontinence

G.Willy Davila 113

6-3 Sling/Tension-Free Vaginal Tape

Gamal M. Ghoniem and Usama M. Khater 115

6-4 Bulking Agents

Raymond R. Rackley and Ahmed Elazab 121

6-5 Retropubic Therapy for Stress Incontinence

Mark D. Walters 127

6-6 Laparoscopic Surgery for Urodynamic Stress Incontinence

Marie Fidela R. Paraiso 133

6-7 Other Therapies for Stress Urinary Incontinence

Tara L. Frenkl and Sandip P. Vasavada 137

6-8 Anal Sphincter Repair

Susan M. Cera and Steven D. Wexner 143

6-9 Fecal Diversion

Benjamin Person, James Doty, and Steven D. Wexner 151

6-10 ACYST, Secca, Sacral Nerve Stimulation, Artificial Bowel Sphincter, and Stimulated Graciloplasty

Susan M. Cera and Eric G. Weiss 155

6-11 Case Presentation: Stress Urinary Incontinence/Fecal Incontinence

Daniel H. Biller and G. Willy Davila 163

SECTION VII Urgency/Frequency Syndromes Therapy


Gamal M. Ghoniem 168

7-1 Overactive Bladder: Pharmacologic Therapy

Daniel H. Biller and G. Willy Davila 169

7-2 Sacral Nerve Stimulation

Joanna M. Togami and Gamal M. Ghoniem 175

7-3 Surgical Management of the Overactive Bladder: Evacuation Disorders

Raymond R. Rackley and Joseph Abdelmalak 181

7-4 Irritable Bowel Syndrome

Ronnie R. Pimentel 187

7-5 Irritable Bowel-Anismus

Wael Solh and Eric G. Weiss 189

SECTION VIII Prolapse Syndromes Therapy


G. Willy Davila 192

8-1 Vaginal Pessaries

Minda Neimark 193

8-2 Vaginal Vault Prolapse Surgery

G. Willy Davila 199

8-3 Anterior Vaginal Prolapse Repairs

Sandip P. Vasavada and Matthew D. Barber 207

8-4 Vaginal Enterocele Repairs

Andrew I. Sokol and Mark D. Walters 217

8-5 Vaginal Rectocele Repairs

Jennifer T. Pollak and G. Willy Davila 223

8-6 Rectal Prolapse Therapy

T. Cristina Sardinha and Steven D. Wexner 229

8-7 Rectoanal Intussusception, Solitary Rectal Ulcer, and Sigmoidoceles

Juan J. Nogueras and Susan M. Cera 233

8-8 Case Presentation: Prolapse

G. Willy Davila and Daniel H. Biller 237

SECTION IX Pain and Irritative Syndromes Therapy


Gamal M. Ghoniem 242

9-1 Interstitial Cystitis-Painful Bladder Syndrome

Gamal M. Ghoniem and Usama M. Khater 243

9-2 Painful Conditions of the Urogenital Sinus

Nathan Guerette and G. Willy Davila 251

9-3 Anal Pain

9-4 Pain Localization and Control

Wagih W. Gobrial 259

9-5 Acupuncture for Pelvic Floor Dysfunction

Lawrence P. Frank 263

SECTION X Evacuation Disorders


Steven D. Wexner 268

10-1 Conservative Management of Urinary Retention in Women

Tara L. Frenkl and Firouz Daneshgari 269

10-2 Surgical Management of Urinary Retention

Raymond R. Rackley and Tara L. Frenkl 275

10-3 Bladder Outlet Obstruction after Anti-Incontinence Surgery/Urethrolysis

Gamal M. Ghoniem and Usama M. Khater 281

10-4 Conservative Management of Constipation

Gregory F. Bonner 285

10-5 Surgical Management of Constipation

SECTION XI Hormonal Influences on the Pelvic Floor

11-1 Hormonal Influences on the Pelvic Floor

G. Willy Davila 295

SECTION XII Physiotherapeutic Approaches


G. Willy Davila 302

12-1 Kegel Exercises and Biofeedback

Dawn Vickers and G. Willy Davila 303

12-2 Timed Voiding and Fluid Management

Marie Fidela R. Paraiso and George Abate 311

12-3 Bowel Retraining for Functional Disorders of the Colon, Rectum, and Anus

Susan M. Cera and Jonathan E. Efron 315

SECTION XIII Surgical Therapy: Mututal and Combined Aspects


G. Willy Davila 320

13-1 Vesico-Vaginal Fistula

Gamal M. Ghoniem and Usama M. Khater 321

13-2 Rectovaginal Fistula

Susan M. Cera and Juan J. Nogueras 325

13-3 Enterourinary Fistula

T. Cristina Sardinha, Samir M. Yebara, and Steven D. Wexner 335

13-4 Management of Urinary Tract Injuries

Gamal M. Ghoniem and John C. Hairston 337

13-5 Combined Versus Sequential Reconstructive Surgeries

G. Willy Davila 341

SECTION XIV Severity Assessment


Steven D. Wexner 346

14-1 Voiding Diary

Gamal M. Ghoniem and Usama M. Khater 347

14-2 Scoring Systems

Wael Solh and Steven D. Wexner 353

14-3 Quality-of-Life Assessment Tools

G. Willy Davila 359


Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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