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Anorectal fistula surgery is associated with risks of recurrence and/or faecal incontinence due to anal sphincter injuries. In order to minimise these complications, preoperative evaluation of the anatomy of the fistula tract and morphology of the anal sphincters is mandatory. Anal endosonography (AES) and Magnetic Resonance Imaging (MRI), due to high resolution of images and ability to identify a number of fistula elements which are important for surgeons in treatment planning, are the methods of choice in the diagnosis of anorectal fistulas.In this paper, a new template for endosonographic and MRI report, systematically describing all anorectal fistula's characteristics, is presented. This template provides practical information for the surgeon, useful in preoperative assessment and postoperative follow-up. [ABSTRACT FROM AUTHOR]

Malformations of the rectum and urinary tract frequently coexist, and the prevalence of urogenital defects in patients with a rectal defect ranges from 20 to 54%. In most patients, anorectal malformations are diagnosed and treated surgically in early childhood. In this report, we present a case of a 52-year-old male with a history of urological operations in infancy due to a congenital urethral malformation and multiple recurrent episodes of perineal abscesses with urinary retention. Anorectal endosonography and magnetic resonance imaging revealed the presence of a large cystic lesion adjacent to the rectal wall which became smaller at the level of the puborectalis. The walls of the lesion had a layered structure identical to the wall of the rectum. In addition, the examinations showed hypotrophy of the left lobe of the prostate and lack of left semnal vesicles. Thus, the lesion was diagnosed as duplication of the rectum or rectal diverticulum. Surgery was performed by an interdisciplinary team of colorectal surgeons and urologist. The lesion was removed laparoscopically. The pathological report revealed that the cystic wall was typical of the intestinal wall, consistent with a diagnosis of rectal duplication. [ABSTRACT FROM AUTHOR]

Full-thickness rectal prolapse (FTRP) is a multifactorial disease; the dominant cause is different in each case. The authors developed an original algorithm for qualifying patients for perineal or abdominal approach based on identification of dominant factor. The validity of the algorithm was assessed by treatment results. The study aimed to assess the results and patients' quality of life after FTRP surgery qualified for various procedures, based on a uniform algorithm. Consecutive 61 patients qualified for surgery due to FTRP from January 2012 and March 2019 were enrolled. The authors qualified for abdominal or perineal approach following a uniform algorithm. The following parameters were assessed before operation and each year after the surgery: constipation, incontinence, EuroQol 5 dimensions (EQ5D), and quality of life scale (QoL). Median follow-up period was 26 months. Investigators compared preoperative assessment and the last obtained follow-up assessment. Recurrence was observed in 5 patients (8.2%); constipation decreased from 41 patients (67.2%) before the surgery to 16 (26.2%) postoperatively. Incontinence score decreased by 51% in postoperative assessment. The Wexner score decreased from 11.7 points before to 6.3 after surgery (p < 0.001). No complications were observed. The QoL improved from 49.8 to 69.8 points after surgery (p < 0.001), and the EQ5D improved from 7.3 to 4 points (p < 0.001). The quality of patients' life, after full-thickness rectal prolapse procedures qualified for surgery according to the proposed algorithm, improved in terms of all measured parameters. The small group requires further studies to confirm the utility of the algorithm. [ABSTRACT FROM AUTHOR]

Introduction: Treatment of the pilonidal sinus, due to various surgical methods, remains the current topic of discussion during surgeon meetings worldwide. The newest methods of treatment consist in the excision and simultaneous closure of the wound with cleft lift procedures. One of such methods is Bascom II procedure which has been widely used in the world but is less popular in Poland. Aim of the study: To evaluate the results of treatment of pilonidal cysts using Bascom II procedure performed by one operator. Material and method: 50 patients (40 men, 10 women), Avg. 30.6 years of age. All patients treated with Bascom II procedure in one surgical ward by one operator (resident during specialisation training) with the use of uniform surgical care for all operational protocols. The following were assessed: BMI, average hospitalisation time, pain, post-operative complications, wound healing time, patient's quality of life, and the recurrences rate after surgery. The follow-up period ranged from 12 to 52 months. Results: Average BMI 27.13 kg/m2. Avg. time of hospitalisation 2.95 days. Post-operative pain in the first 24 hours was on average 4.55 points. (+/- 2.24 points); on the 10th day on average 2.04 points (+/- 1.58 points); in the 30th day on average 0.76 points (+/- 1.1 points). Pain after healing 0.14 points (+/- 0.40 points). Post-operative complications occurred in 28.57% of patients [partial wound dehiscence (16.32%), serum leak (10.2%), hematoma (6.12%), total wound dehiscence (0%), wound infection (0%)]. The average time of full healing was 2.94 weeks. Recurrence occurred in one patient (2.04%). Conclusions: Bascom II procedure is characterised by a low recurrence rate and short wound healing time. It is a a safe, effective and patient-accepted method of treatment. Statistically, it significantly improves the patient's quality of life one year after surgery in terms of both physical and mental health. [ABSTRACT FROM AUTHOR]

A rare case of a giant vulvar lipoma that developed in an adolescent is presented. A review of the world literature of 15 cases that occurred prior to adulthood confirmed that they tend to occur on the right side of the vulva. [ABSTRACT FROM AUTHOR]