• The Korean Journal of Pain
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• v.8 no.2
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• pp.363-366
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• 1995

Blockade of the ganglion impar was performed as an alternertive means of managing intractable neoplastic perineal pain of sympathetic origin. We successively treated a patient who had suffered from excessive perianal sweating with ganglion impar block using pure alcohol. Eight months after block, the patient has no complaint of perianal sweating. Ganglion impar block is an effective method in the treatment of excessive perianal sweating as well as perineal pain of sympathetic origin.

• The Korean Journal of Pain
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• v.20 no.2
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• pp.251-254
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• 2007

Perineal pain is a significant diagnostic challenge to the pain practitioner, and accurate diagnosis and treatment is essential. We report a case of 42-years old female patient suffering from excruciating vulvodynia for 5 years. Her pain on the visual analogue scale was 10 out of 10 and her pain was associated with sleep disturbance, dyspareunia, and chronic fatigue. She was diagnosed with a bladder stone by imaging, and The pain was relieved by cystolitholapaxy.

• Journal of Minimally Invasive Surgery
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• v.21 no.4
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• pp.177-179
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• 2018

A rectocele with a weakened rectovaginal septum can be repaired with various surgical techniques. We performed laparoscopic posterior vaginal wall repair and rectovaginal septal reinforcement without mesh using a modified transperineal approach. A 63-year-old woman with outlet dysfunction constipation complained of lower pelvic pressure and sense of heaviness for 30 years. Initial defecography showed an anterior rectocele with a 45-mm anterior bulge and perineal descent. Laparoscopic procedures included peritoneal and rectovaginal septal dissection directed toward the perineal body, rectovaginal septal suturing, and peritoneal closure. The patient started a soft diet the following day and was discharged on the 5th postoperative day without any complications. The patient had no dyschezia or dyspareunia, and no problem with bowel function; 3-month follow-up defecography showed a decrease in bulging to 18 mm. Laparoscopic posterior vaginal wall and rectovaginal septal repair is safe and feasible for treatment of a rectocele, and enables early recovery.

• CELLMED
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• v.11 no.4
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• pp.17.1-17.4
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• 2021

Episiotomy is the commonest obstetrics intervention in the world to reduce severe perineal injuries. Its prevalence is 43% to 100% in primiparous women in Asia. Further, worldwide approximately 10-95% of pregnant women undergo episiotomy incision during birth. Delay in wound healing probably increases the risk of wound infection, changes the muscular structure, and ultimately causes muscle tone loss. So, wound care is of specific significance to postnatal maternal outcomes. Hence, this case study aimed to evaluate the effect of Marham-i-Raal in episiotomy wound healing and pain relief. The study was conducted in eleven postpartum primi or multipara pregnant women aged between group 19 and 35 years with term gestational age, singleton pregnancy in a cephalic presentation who had a normal vaginal delivery with mediolateral episiotomy, without a perineal tear, and perineal hematoma. Externally, application of Marham-i-Raal 2g on episiotomy incisional wound, twice a day for 10 days was advised. Wound healing of episiotomy and pain intensity was assessed with REEDA ["redness, oedema, ecchymosis, discharge and approximation of the edges"] scoring and VAS scoring for pain intensity respectively. At one hour (baseline), the REEDA mean score of eleven patients was 3.90±1.04 whereas on day 7-10 it was 0.18±0.40 with statistically significant difference (p<0.001). The VAS mean score at one hour was 6.90±1.22 whereas on day 7-10 it was 0.72±0.78 with a statistically significant difference (p<0.001). Marham-i-Raal would be effective in episiotomy wound healing and reducing pain intensity. Further, randomized double-blind controlled trials in large sample size are recommended.

• Journal of Korean Academy of Nursing
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• v.11 no.1
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• pp.19-27
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• 1981

This Study was conducted at Intensive Care Unit of H & S Hospitals from Jan 4 to April 7, 1981 on 14mail & 26female adult patients. Each patient was screened and found to have nonbacteriuria in clean catch specimen before catheterization. Clean catch apecimen through Foley catheter were obtained after 24hours, 48hours and 72hours from catheterization. The result of this study is reviewed in a statistical analysis of percentage ＆ Chi Square test to obtain the following findings. 1) The occurenc of bacteriuria in patients according to duration of indwelling catheter. a. 9.1％ of the patient showed evidence of bacteriuria 24hours post catheterization specimen and 60％ showed 48hours post cathetreization, while 68.4％ of the patient showed evidence of bacteriuria 72hours post catheterization specimen. The occurence of bacteriuria in patients were significant differences at 1％ level between duration of indwelling catheter. b. Mail patients had no infection 24hours post catheterization, 50％ displayed bacteriuria 48hours post catheterization ＆ 62.5％ displayed bacteriuria 71hours post catheterization. 11.1％ of femail patients displayed infection 24hours post catheterization 66.7％ displayed infection 48hours post catheterization and 72.7％ displayed infection 72hours post catheterization. There were significant differences at 1％ level between bacteriuria occurence of mail ＆ femail patients and the duration of insertion. 2) 56％ of those patient who have altered mental state developed bacteriuria, while 40％ of those patient who have alear mental state developed bacteriuria. But there was without statistically any significant difference between patient's mental status. 3) The occurence of bacteriuria with the administration of antibiotics in 36 patient was in 50％. The occurence of bacteriuria without the administration of antibiotics in 4 patients was in 50％. But there was without statistically any significant difference between the administration of antibiotics. 4) The occurence of bacteriuria in patients according to frequency of bladder irrigation. 50％ of those patient who irrigated twice a day developed bacteriuria, 63.6％ of those patient who irrigated once a day developed bacteriuria. The occurence of bacteriuria in patients were significant differences at 1％ level between frequency of bladder irrigation. 5) The occurence of bacteriuria in patients who did perineal care once a day was 58.1％, 22.6％ of those patient who did perineal care twice a day developed bacteriuria. But there was without statistically any signiticant differences between frequency of perineal care. 6) Most frequent bacteria of all bacterial strains isolated by culture of the urine was E. coli(45％). Enterococci & Staphylococcus were 15％ respectively.

• The Korean Journal of Pain
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• v.9 no.2
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• pp.415-418
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• 1996

The first reported the neural blockade of ganglion impar for pain control of perineal pain in 1990 by Plancarte and his fellows. they used 6ml of 10 percent phenol. but the point of issues, same as other neurolytics, are that it is impossible to check and control its spreading, so it might be possible to destruct the coccygeal plexus and sacral nerve, and also it has only short action time. Because of these problems, it could be very dangerous to attempt this procedure especially not for relieving the pain on cancer terminal patient, but for the sympathectomy of ganglion impar on the other purpose. We used the RF generator which had the control ability to point out the destructive lesion accurately. inserted We made the small burr hole on the sacrum near the sacrococcygeal junction directly, through the hole, and performed thermocoagulation to the ganglion impar.

• Archives of Plastic Surgery
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• v.43 no.5
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• pp.461-465
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• 2016

Extramammary Paget's disease (EMPD) is a rare, slow-growing intraepithelial malignancy that mainly involves the genital region, including the vulva, penis, scrotum, perianal, and periurethral areas. Although several treatment options exist, wide local excision with a safe margin is considered the treatment of choice. After resection of the lesion, it is often challenging to reconstruct the defect because defects in the perineal region require adequate volume for protection and are susceptible to infections, which is a particularly significant risk for large defects. We report a case of perivulvar EMPD that was reconstructed with three-directional local flaps after wide excision of the tumor. We covered the defect sequentially using the following 3 flaps: a gracilis myocutaneous flap from the left thigh, a bipedicled V-Y advancement flap from the lower abdomen, and an internal pudendal artery perforator-based island flap from the right buttock. To the best of our knowledge, this report is the first to describe a three-directional approach to extensive perivulvar reconstruction.

• The Korean Journal of Pain
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• v.10 no.2
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• pp.254-257
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• 1997

Ganglion impar lies immediately anterior to the sacrococcygeal junction and blockade of the ganglion is used to treat anorectal and perineal pain. Although the technique introduced by Plancarte et at is widely practised, the bent needle is sometimes difficult to position precisely and patients find the procedure painful. We modified this approach of block of ganglion impar by positioning the needle into the sacrococcygeal junction and using the loss of resistance technique. With the patient in the lateral position, a skin wheal was raised at 1-1.5cm below the sacral hiatus. Twenty-three gauge short needle was directly placed into the sacrococcygeal junction with aid of fluoroscopic guidance. From 1 cm behind the anterior margin of the vertebral body in lateral view, we used the loss of resistance technique to confirm the retroperitoneal space. We found this modified approach easier to perform during six blocks for three patients with anorectal or perineal pain. Our modified approach through the sacrococcygeal junction may provide opportunity for wider administration of this procedure because of its simple technique, reduced pain during procedure and decreased risk of infection.

• Korean Journal of Veterinary Research
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• v.31 no.4
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• pp.519-522
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• 1991

Pain reflex and anesthetic state in swine with xylazine epidural anesthesia were observed. In xylazine epidural anesthesia, dosages of 0.50mg/kg BW for analgesia of perineal region and 0.7550mg/kg for analgesia of low abdominal wall were required. Regional anesthesia was induced 5~20 min after epidural injection of xylazine and recovered 90~120 min after administration. The results indicated that xylazine as an epidural local anesthetic was useful in swine.

• Journal of the korean veterinary medical association
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• v.27 no.11
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• pp.675-677
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• 1991

This study was designed to examine the effect of xylazine (0.07mg/kg suspended in 5ml saline) given into the epidural space in 11 Holstein cows. Analgesic state was induced at the perineal region within 10 min after administration of xylazine and at the u