​This book aims to address all degrees of perineal trauma as well as interventions to reduce the risk of their occurrence and management of future pregnancies​. Perineal trauma affects a significant number of women worldwide every year. The inadequate assessment and management of perineal trauma can cause significant complications to women at a very critical time of their life. These can consequently lead to serious long-term problems.

​This book aims to address all degrees of perineal trauma as well as interventions to reduce the risk of their occurrence and management of future pregnancies​. Perineal trauma affects a significant number of women worldwide every year. The inadequate assessment and management of perineal trauma can cause significant complications to women at a very critical time of their life. These can consequently lead to serious long-term problems.

This book clarifies and explains perineal anatomy and the pathophysiology of anal incontinence as well as applied pharmacology. It also institutes the new recommended classification of perineal tears, and describes anal sphincter repair techniques. The emphasis is on correct post-operative management, management of pregnancy following previous anal sphincter injury, and prevention of anal sphincter tears. The book will interest students, colorectal surgeons, physiotherapists, midwives, continence advisors, labour wards and lawyers.

"According to the International Association for Ambulatory Surgery (IAAS), ambulatory surgery should be defined as: 'an operation/procedure, excluding an office or outpatient operation/procedure, where the patient is discharged on the same working day'. The origins of ambulatory surgery can be traced back to the pioneering work of James Nicholl at the Glasgow Royal Hospital who reported 8988 paediatric day case procedures between 1899-1908. Despite initial scepticism from the surgical profession, there has been a rapid expansion in the complexity and amount of ambulatory surgery in recent years: between 1989-2003 the percentage of elective surgery undertaken as day case in the UK increased from 15% to 70%. Many health services have set targets for the percentage of elective surgeries to be done as day-case procedures and in the UK this target is set at 75%"--

First book devoted to the diagnosis and treatment of sexual pain in women Female Sexual Pain Disorders is a remarkable fusion of clinical and scientific knowledge that will empower women’s healthcare professionals to help their patients in overcoming this common debilitating disorder. Based on the highest level research, it provides state-of-the-art practical guidance that will help you to: Evaluate and distinguish the causes of sexual pain in women Differentiate the many forms of sexual pain Implement multidisciplinary treatments Distilling the experience of world leaders across many clinical, therapeutic and scientific disciplines, with an array of algorithms and diagnostic tools, Female Sexual Pain Disorders is your ideal companion for treating the many millions of women who suffer from this disorder worldwide. All proceeds from this book are being donated to the International Society for the Study of Women’s Sexual Health (ISSWSH).

This comprehensive and authoritative text takes an integrated approach to childbirth trauma, focusing on anal sphincter injuries and perineal morbidity, as well as other lower urinary tract dysfunctions secondary to childbirth. ​In recent years there has been an increasing emphasis on childbirth injury. Research based on clinical evaluation and anal ultrasound has improved our understanding of these significant childbirth related complications, their associated morbidity and their long-term sequelae. Despite extensive research interest, clinical focus and institutional national and international guidelines, outcomes are still not optimal and debates continue. Complete with full-color illustrations, Childbirth Trauma is a useful guide for clinicians and researchers in this field.

Book description to come.

Background: Obstetric perineal lacerations are common after vaginal birth. The degree of obstetric perineal laceration is defined by the extent of tissue involved in the laceration. When a perineal laceration has occurred after vaginal delivery, the examination for correct diagnostics is essential before primary suturing. Standard immediate postpartum care is an inspection and palpation of the obstetric perineal laceration. The aim of this thesis was to explore the diagnostics of obstetric perineal lacerations, and to examine how the methods of bidigital perineal palpation and transperineal ultrasound postpartum can contribute to the clinical diagnostic decisions before primary repair. Material and Methods: Study I is a methodological study of transperineal ultrasound of the anovaginal distance. The learning curve and inter-observer agreement of the method is studied between three examiners in an outpatient gynaecological setting. Study II is a prospective observational study of 150 primiparous women with suspected perineal laceration of degree 2-3 immediately after childbirth and the association between bidigital palpation of the perineal height, the anovaginal distance and the final diagnosis of the perineal laceration. Study III is a retrospective observational study with data from the Swedish national Perineal Laceration Registry, studying maternal and obstetric risk factors for internal anal sphincter injury in 3,333 women with external sphincter injury. Study IV is a follow-up study focusing on the implementation strategies and outcome when introducing a new method, (the Diagnostics After DELivery – DADEL concept) for examining perineal lacerations at a maternity ward. The DADEL concept consists of a combination of bidigital palpation of the perineal tissues and transperineal ultrasound in order to determine the degree of perineal lacerations. Results and conclusions: In study I, the method of transperineal ultrasound measurement of anovaginal distance revealed a short learning period and high interobserver agreement. This indicated that the method can be taught and reliably used in further research and clinical practice. In study II, women with external sphincter injury had a shorter anovaginal distance compared to women without this injury. The palpatory perineal thickness was associated with the anovaginal distance. Study III showed that 33% of primiparous women with an external anal sphincter injury also had an internal anal sphincter injury diagnosed immediately after delivery. When the infant was born with a hand or arm beside the head, there was an increased risk for internal anal sphincter injury. Perineal palpatory thickness of less than 10 mm was significantly associated with an internal anal sphincter injury. In the follow-up study of diagnostic methods showed a significantly higher use of bidigital palpation five years after introduction of the DADEL concept. The use of transperineal ultrasound showed no significant change during the same period.

Pelvic Floor Re-education encompasses a variety of techniques for increasing the strength of, and control over, the pelvic floor muscles. These techniques are now emerging as an effective and viable alternative to surgery in the treatment of urinary incontinence and related conditions. This volume presents a reasoned, scientific approach to the use of pelvic floor re-education. Starting with the latest theories on anatomy, pathophysiology and possible causes of pelvic floor damage, the text then describes the importance of pelvic floor evaluation in determining the type of treatment required. A number of re-education techniques are assessed including isolated muscle exercise, vaginal cones, biofeedback control and electrical stimulation. Recent research work is also reviewed which allows the reader to evaluate the different modalities advocated in the management of pelvic floor dysfunction.

Global and national confidential inquiry reports show that 60 to 80% of maternal and neonatal morbidity and mortality are due to avoidable errors. This comprehensive and illustrated second edition offers a practical guide to the management of obstetric, medical, surgical, anaesthetic and newborn emergencies in addition to organisational and training issues. The book is divided conveniently into nine sections and updated throughout in line with modern research and practice. Several new chapters cover setting up skills and drills training in maternity services to reduce avoidable harm, managing obstetric emergencies during 'home births' and in low-risk midwifery units, and minimizing maternal and fetal morbidity in failed operative vaginal delivery. Each chapter includes a practical algorithm for quick reference, the scientific basis for proposed actions, a case-based practical exercise and useful learning tools such as 'Key Pearls' and 'Key Pitfalls'. An invaluable resource for obstetricians, neonatologists, midwives, medical students, anesthesiologists and the wider perinatal team.