Posterior hernia of the rectum after coccygectomy

García, Francisco Martín; Franco, Juan de Dios; Marquez, R.M.; Martínez, José Antonio Torralba; Medina, Jaime

doi:10.1080/110241598750005462

Cited by 16 publications

(22 citation statements)

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“…The majority were infections that resolved with antibiotic treatment or surgical debridement. Although such complications have been previously reported as rectum prolapsus and rectal injuries following coccygectomy [35], we were not able to confirm them in this systematic review. We were also unable to identify a direct relationship between infection and poor outcome.…”

Section: Discussioncontrasting

confidence: 66%

Surgical treatment of coccygodynia: an analytic review of the literature

2010

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Coccygodynia is a pathological condition associated with pain-discomfort all around the bottom end of the spine. The aetiology and the intensity of the symptoms may defer significantly. The effectiveness of the surgical treatment remains obscure. Our purpose, through this systematic review is to evaluate the results of surgical treatment of coccygectomy. Literature retrieval was performed by the use of the PubMed searching engine utilising the terms 'coccygodynia-coccygectomy' in the English language from January 1980 to January 2010. Case reports and tumour related case series were excluded as well as articles published in other languages. In total 24 manuscripts were analyzed. Only 2 of them were prospective studies whereas 22 were retrospective case series; five were classified as Level III studies and the remaining as Level IV studies. In total, 671 patients with coccygodynia underwent coccygectomy following failed conservative management. The sex ratio, male/female was 1:4.4. The most popular aetiology for coccygodynia was direct trauma in 270 patients. 504 of the patients reported an excellent/ good outcome following the procedure. There were 9 deep and 47 superficial infections. Other complications included two haematomas, six delayed wound healings and nine wound dehiscence. The overall complication rate was 11%. Patients with history of spinal or rectal disorders, as well as idiopathic or with compensation issues, had less predictable outcome than those with history of trauma or childbirth. Coccygectomy can provide pain relief to as high as 85% of the cases. The most common reported complication was wound infection.

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Section: Discussioncontrasting

confidence: 66%

Surgical treatment of coccygodynia: an analytic review of the literature

2010

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“…Remarkably, reports on postoperative complications are uncommon, apart from bacterial wound infection (due to the close proximity of the anus) (Karadimas et al,2011). Posterior rectal herniation from weakening of the pelvic floor is rare (Garcia et al,1998; Miranda et al,2009). There appear to be no reports of neurologic deficits but detailed postoperative assessments are lacking.…”

Section: Resultsmentioning

confidence: 99%

Clinical anatomy of the coccyx: A systematic review

Woon

Stringer

2011

Clinical Anatomy

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The coccyx has been relatively neglected in anatomical research which is surprising given the population prevalence of coccydynia and our inadequate understanding of its etiology. This systematic review analyzes available information on the clinical anatomy of the coccyx. A literature search using five electronic databases and standard anatomy reference texts was conducted yielding 61 primary and 7 secondary English-language sources. This was supplemented by a manual search of selected historical foreign language articles. The coccygeal vertebrae, associated joints, ligaments and muscles, coccygeal movements, nerves, and blood supply were analyzed in detail. Although the musculoskeletal aspects of the coccyx are reasonably well described, the precise anatomy of the coccygeal plexus and its distribution, the function of the coccygeal body, and the anatomy of the sacrococcygeal zygapophyseal joints are poorly documented. Further research into the anatomy of the coccyx may clarify the etiopathogenesis of coccydynia which remains uncertain in one-third of affected patients.

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“…The coccygeal plexus gives rise to anococcygeal nerves which are likely to supply skin in the anococcygeal region (and the deeper midline anococcygeal ligament). However, the cutaneous innervation of Co1 is almost certainly not an autonomous zone but a region of overlapping dermatomes since perineal numbness is not reported as a complication of coccygectomy despite the inevitable trauma to Co1 (Garcia et al, ; Miranda et al, ; Karadimas et al, ). Medial fibers from the coccygeal plexus probably innervate coccygeal periosteum and ligaments and may convey autonomic fibers to the coccygeal body and sacrococcygeal joint.…”

Section: Discussionmentioning

confidence: 99%

Redefining the coccygeal plexus

Woon

Stringer

2013

Clinical Anatomy

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The coccygeal plexus is variably described in anatomy texts and has rarely been studied despite the idiopathic nature of coccydynia in up to one-third of affected patients. The plexus was therefore investigated using a combination of microdissection and histology. The distal sacrum and coccyx in continuity with ischiococcygeus were removed en bloc from 16 embalmed cadavers (mean age 78 ± 10 years, 7 females) with no local disease. Ten specimens underwent microdissection of the coccygeal plexus and the remaining six were examined histologically after staining with hematoxylin and eosin and S100 immunohistochemistry to demonstrate nerve fibers. The coccygeal plexus is formed within ischiococcygeus from the ventral rami of S4, S5, and Co1 with a contribution (gray rami communicantes) from the sacral sympathetic trunk. It gives rise to anococcygeal nerves which pierce ischiococcygeus and the sacrospinous ligament to supply the subcutaneous tissue on the dorsal aspect of the coccyx. Some branches from the plexus pass medially anterior to the coccyx. The coccycgeal plexus is formed within ischiococcygeus rather than on its pelvic surface and appears to supply skin in the anococcygeal region. It probably also contributes to the innervation of ischiococcygeus, the sacrospinous ligament, coccygeal ligaments, and periosteum. It deserves to be considered as a potential pain generator that may be implicated in some patients with coccydynia.

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Posterior hernia of the rectum after coccygectomy

Cited by 16 publications

References 0 publications

Surgical treatment of coccygodynia: an analytic review of the literature

Surgical treatment of coccygodynia: an analytic review of the literature

Clinical anatomy of the coccyx: A systematic review

Redefining the coccygeal plexus

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