Internal anal sphincterotomy plus free dilatation versus anal stretch with special criticism of the anal stretch procedure for hemorrhoids

1974 ◽  
Vol 17 (4) ◽  
pp. 493-522 ◽  
Author(s):  
Stephen Eisenhammer
Keyword(s):  
Anal Stretch

Acute anal stretch inhibits NMDA-dependent pelvic-urethra reflex potentiation via spinal GABAergic inhibition in anesthetized rats

2008 ◽  
Vol 295 (4) ◽  
pp. F923-F931 ◽  
Author(s):  
Sung-Lang Chen ◽  
Yu-Hui Huang ◽  
Yu-Lin Kao ◽  
Gin-Den Chen ◽  
Chen-Li Cheng ◽  
...  
Keyword(s):  
Receptor Antagonist ◽  
Repetitive Stimulation ◽  
The Other ◽  
Spinal Reflex ◽  
Gabaergic Neurotransmission ◽  
Single Action ◽  
Anesthetized Rats ◽  
Other Hand ◽  
Anal Stretch ◽  
The Impact

The impact of acute anal stretch on the pelvic-urethra reflex potentiation was examined in urethane-anesthetized rats by recording the external urethra sphincter electromyogram activity evoked by the pelvic afferent stimulation. Test stimulation (1 stimulation/30 s) evoked a baseline reflex activity with a single action potential that was abolished by gallamine (5 mg/kg iv). On the other hand, the repetitive stimulation (1 stimulation/1 s) induced spinal reflex potentiation (SRP) that was attenuated by intrathecal 6-cyano-7-nitroquinoxaline-2,4-dione (a glutamatergic α-amino-3-hydroxy-5-methyl-4-isoxazoleproprionat receptor antagonist, 100 μM, 10 μl) and d-2-amino-5-phosphonovalerate [a glutamatergic N-methyl-d-aspartate (NMDA) antagonist, 100 μM, 10 μl]. Acute anal stretch using a mosquito clamp with a distance of 4 mm exhibited no effect, whereas distances of 8 mm attenuated and 12 mm abolished the repetitive stimulation-induced SRP. Intrathecal NMDA (100 μM, 10 μl) reversed the abolition on SRP caused by anal stretch. On the other hand, pretreated bicuculline [γ-aminobutyric acid (GABA) A receptor antagonist, 100 μM, 10 μl] but not hydroxysaclofen (GABAB receptor antagonist) counteracted the abolition on the repetitive stimulation-induced SRP caused by the anal stretch. All of the results suggested that anal stretch may be used as an adjunct to assist voiding dysfunction in patients with overactive urethra sphincter and that GABAergic neurotransmission is important in the neural mechanisms underlying external urethra sphincter activity inhibited by anal stretch.

Urodynamic Responses to Anal Stretch in Patients With Detrusor Sphincter Dyssynergia

2008 ◽  
Vol 89 (9) ◽  
pp. 1748-1752 ◽  
Author(s):  
Yu-Hui Huang ◽  
Sung-Lang Chen ◽  
Su-Ju Tsai ◽  
Liu-Ing Bih ◽  
Henry L. Lew
Keyword(s):  
Detrusor Sphincter Dyssynergia ◽  
Anal Stretch

Anal stretch for chronic anal fissure: an old operation that stood the test of time

2012 ◽  
Vol 404 (S1) ◽  
pp. 9-10 ◽  
Author(s):  
Andrea Cariati ◽  
Elisa Piromalli ◽  
Francesco Copello ◽  
Iliana Torelli
Keyword(s):  
Anal Fissure ◽  
Chronic Anal Fissure ◽  
Anal Stretch

scholarly journals Value of an Anal Dilator after Anal Stretch for Haemorrhoids

1981 ◽  
Vol 74 (5) ◽  
pp. 368-370 ◽  
Author(s):  
F Greca ◽  
E Nevah ◽  
M Hares ◽  
M R B Keighley
Keyword(s):  
Randomized Trial ◽  
Prospective Randomized Trial ◽  
Anal Stretch ◽  
Anal Dilator ◽  
Additional Therapy

A prospective randomized trial compared anal stretch with or without continued dilatation for three months in 89 consecutive patients with haemorrhoids. Complications of therapy occurred in only 4 patients, 3 of whom had transient incontinence of flatus. When patients were reviewed four months after treatment, only 4 of 44 patients (9%) who used a dilator had not been improved and required additional therapy, compared with 15 of 42 patients (36%) who had anal stretch alone (P <0.02). It is concluded that the use of an anal dilator improves the results of anal stretch.

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