استكشف المجموعة الواسعة من العناوين المتاحة.

\"The first part of the book covers anatomy and biomechanics of the pelvis, and the second part includes 26 exercises for yoga practitioners and students specifically focused on strengthening the pelvis\"-- Provided by publisher.

Aim: To evaluate the level of knowledge of vaginismus in its psychological and sexual causes, the use of medical hypnosis as a therapeutic support, and to create an ad hoc hypnotic model for its treatment trough a grid comprising all dimensions used in the various researches considered in the literature. Methods: The review was performed by consulting the electronic Medline database (PubMed), DSM IV-TR and 5, Benini’s biopsychosocial relational theories, and extracts abstracts data from various medical and sexology publications. Results: The vaginismic woman seems to present a psychobiological vulnerability, mainly triggered by hyperactivity of the emotional sphere and by a muscular hypertonus of the pelvic floor that influences the sexual sphere. The data support the idea of a general defensive reaction as a mechanism of involuntary muscular activity of the pelvic floor and a close connection between vaginismus, pelvic contraction, emotional motor system and biological anguishes of the reptilian mind. Conclusions: Further to the effectiveness of a multidisciplinary-approach in the treatment of vaginismus, hypnosis seems to have an impact in shortening therapy time, in pain management and anxiety reduction. According to Benini’s approach, the cause of vaginismus is not identified in the fear of penetration but rather in the anguish of the reptilian mind.

Objectives: There is a known increased prevalence of abductor tears in patients with increased age and female gender. This study’s purpose is to identify radiographic risk factors (RRF) and radiographic signs of abductor tendon tears. Methods: Patients with intraoperative diagnoses of abductor tear were included in this study and were matched by age ±5 years, gender, and BMI ±5 with patients who had no abductor pathology by clinical exam and MRI. An AP pelvis radiograph was performed on all patients. The radiographs were evaluated for RRF (pelvic width, body weight moment arm, abductor moment arm, abductor angle, pelvic height) and signs of abductor tendon pathology (greater trochanteric excrescence). Femoral version was measured on MRI when images were available. Results: There were 152 patients with abductor tears identified intraoperatively. All were treated with surgical repair. These patients were matched as described previously. The RRF found were an increased tear drop to tear drop distance (14.8 for abductor tears vs. 14.3 for control; p<0.001), body weight moment arm (11.1 vs. 10.9; p<0.001), abductor moment arm (7.8 vs. 7.6; p<0.001), decreased femoral anteversion (7.6 vs. 10.6; p=0.045), and excrescence presence (41% vs. 3%; p<0.001). An excrescence of the greater trochanter had a specificity of 97%, PPV of 94% and a positive likelihood ratio of 12.8 for abductor tears. Conclusion: Patients with abductor tears have a wider pelvis, longer abductor moment arm, longer body weight moment arm, less femoral anteversion, and have greater trochanteric excrescence noted on nearly half of patients with an abductor tear. Presence of an excrescence was noted to have a positive predictive value of 94%, specificity of 97%, and positive likelihood ratio of 12.75, suggesting that if noted on radiograph, the care provider should have a very high index of suspicion for abductor tendon tear.

[This corrects the article DOI: 10.1371/journal.pntd.0008183.].

Tension free vaginal tape (TVT) has become the treatment of choice for females with stress incontinence (SUI), since the first description from Ulmsten and Petros, in 1995. Success rate for TVT, as long as for the later described supporting the mid-urethra transobturator tapes, have been found high. Complications frequency is low for all types of tapes, but complications do still appear. The necessity for decreased complications led to the development of new supporting tapes such as TVT-secur and Needleless. Success rates concerning continence and quality of life have been evaluated and published, but complications rates and their treatment options still remain controversial. Purpose: To present the complications following application of mid- urethra supporting tapes and pelvic floor grafts, in order to treat SUI and pelvic floor prolapse respectively.

Background: Femoroacetabular impingement (FAI) is a dynamic degradative condition of the hip joint characterized by classic physical exam findings in combination with abnormal radiographs and/or MRI. Although this abnormal morphologic relationship contributes to FAI, the role of physical therapy to mitigate symptoms by improving strength and mobility of the hip remains the first line treatment. Despite this common treatment algorithm, limited knowledge exists on the effects of sagittal balance, lumbopelvic mobility, and its role in the development of treatment for symptomatic FAI. Hypothesis/Purpose: To review lumbopelvic mobility from standing to sitting position in adolescent athletes who present with clinical signs of FAI. Methods: Pelvic radiographic measurements in the sagittal plane were performed on a retrospective series of consecutive patients who presented with clinical diagnosis of FAI at a pediatric sports medicine institution from April 2019-March 2021. Standardized EOS dynamic lateral pelvic images were performed in standing and sitting positions to evaluate the differences in sacral slope, pelvic tilt, and pelvic incidence. Data from bi-positional radiographs were combined with standard measurements for FAI obtained on AP pelvis (lateral center edge angle, acetabular inclination) and 45 degree Dunn views (alpha angle), and patient reported outcomes (PROs) (mHHS, HOOS, UCLA). Differences in sacral slope from pre-treatment radiographs were used to determine comparison groups: those with a change vs. those with limited change between a sitting and standing position. Results: 76 adolescent patients (mean age 15.7 years [12-24]; 71.5% females) with sitting/standing lateral pelvis radiographs and a clinical diagnosis of FAI were identified. Between sitting and standing positions, there was no change in pelvic incidence, while significant differences were noted in sacral slopes and pelvic tilt (Table 1). Variability in sacral slope differences between sitting and standing were identified with 10 (13.9%) patients having minimal (<10o) change, while 8 (11.1%) demonstrated changes > 40o (Figure 1). Adolescent patients with FAI who demonstrated more mobility from sitting to standing position had a higher sacral slope in the standing position. No correlations were noted between pelvic incidence or sacral slope and radiographic measures associated with FAI, PROs or differences in those with variable changes in sacral slope from sitting to standing position. Conclusion: Lateral pelvic imaging may be an important tool for understanding dynamic hip impingement. In adolescent patients signs and symptoms with clinical FAI, significant variability exists in lumbopelvic mechanics, regardless of the severity of radiographic values. Table 1. Radiographic measurements performed on a sitting and standing lateral pelvic radiographs using EOS. Values listed are mean (standard deviation; range). Figure 1. Sitting and Standing lateral pelvic images from 2 patients. Top row: Standing lateral pelvis (A) and sitting lateral pelvis (B) with a significant change in sacral angle and pelvic tilt with no changes in pelvic incidence. Not the change in lumbar lordosis in this patient. Bottom row: Standing lateral pelvic (A) and sitting lateral pelvic (B) without significant change in lumbosacral position.