Fecal incontinence risk factors and pregnancy.

MATERIALS AND METHODS: We conducted an analysis on 231 pregnant women. A proctologist examined the patients three times: in the 1st trimester (within the first 15 weeks), in the 3rd trimester (29-40 weeks), and 12 months after childbirth. RESULTS: The total number of fecal incontinence observations among women included in the study was 66 cases (28.6%), detected at the final visit. Risk factors for fecal incontinence with a high probability were age over 36 years (P = 0.001), low physical activity (P = 0.034), three or more pregnancies resulting in childbirth (P = 0.022), history of hemorrhoids (P = 0.027), perianal discomfort on the first visit (P = 0.045), and constipation on the first visit (P = 0.006). Factors such as being overweight, marital status, education, living conditions, living area, and infant size did not have significance for fecal incontinence. DISCUSSION: Pregnancy- and obstetric-related risk factors contributing to fecal incontinence are multifactorial, including factors such as multiple childbirths with trauma to the pelvic muscles or anal sphincter muscles, chronic constipation, age, and vaginal deliveries. However, currently, there is no clear concept for the prevention of fecal incontinence in pregnant women. CONCLUSION: The prevalence of fecal incontinence among pregnant women is 12.9%, which increases to 28.6% one year after childbirth. The most common complaint was involuntary passage of intestinal gas. Risk factors for fecal incontinence with a high probability included being over 36-years old, low physical activity, three or more pregnancies resulting in childbirth, a history of hemorrhoids, perianal discomfort, and constipation in the 1st trimester of pregnancy.

[Optimization of surgical tactics in an acute adhesive ileus].

The results of treatment of 157 patients, suffering an acute adhesive ileus (AAI), were analyzed. Indications for laparoscopic and open adhesiolysis were substantiated. There was established, that laparoscopic adhesiolysis is effective in patients in adhesions process (AP) of I - II stages on the height of a seizure. Conduction of laparoscopic adhesiolysis after AAI elimination, using conservative methods in patients with AP I - III stages is effective and constitutes one of prophylactic methods for the adhesions disease recurrence and AAI.

[Immediate and remote results of pylorus-preserving and pylorus-reducing operations in complex surgical treatment of perforated pyloric-duodenal ulcers]. / Neposredstvennye i otdalennye rezul'taty primeneniia pilorosokhraniaiushchikh i pilorovosstanavlivaiushchikh operatsii v komplekse khirurgicheskogo lecheniia perforativnoi piloroduodenal'noi iazvy.

The results of surgical treatment of 224 patients with perforated pyloroduodenal ulcers were analyzed. 110 patients were operated using pyloruspreserving and pylorusreducing methods. The new method of pyloroduodenoplasty is suggested. Duodenogastral reflux after pyloruspreserving operations is arised in 4.5% of observations, after pylorusdestructive--in 46.7%.

[Endoscopic choledochoduodenostomy]. / Endoskopichna kholedokhoduodenostomiia.

Method of endoscopic choledochoduodenostomy was elaborated and introduced in clinical practice. Results of formation of endoscopic biliodigestive anastomosis in 12 patients for 1990-2000 yrs period were analyzed. In 7 (5.8%) patients complications occurred, 1 (0.8%) patient died.

[Experience in the application of iodine-diceryn in the treatment of purulent wounds]. / Opyt primeneniia iod-ditserina v lechenii gnoinykh ran.

Comparative results of treatment of 103 patients with purulent-inflammatory diseases of soft tissues are presented. In patients of a main group iodine-dicerin was applied locally and in control group generally accepted treatment was conducted. Using iodine-dicerin the results of treatment were significantly better, the stationary treatment course was two times shorter than in a control group of patients.