Constipation

Lifestyle advices such as increasing fluid and fibre intake, improving physical activity level, and taking the ideal posture for defecation (squatting position) with a two-pages document.

Standard bowel management

Abdominal massage will be performed three days a week for four weeks. Each session will last around 15-20 minutes.

Abdominal massage

Placebo ultrasound (US) will be applied to the abdominal region for four weeks, 2 days of the week and 15 minutes per day.

Placebo Ultrasound

Ceren Orhan

The Effects of Abdominal Massage on Functional (Primary) Chronic Constipation

Constipation Severity Instrument (CSI) will be used to evaluate the severity of the constipation. CSI was designed to evaluate defecation frequency and consistency as well as the level of straining experienced by individuals during bowel movement. There are three subscales of CSI, obstructive defecation (OT), colonic inertia (CI), and pain. Higher scores of CSI indicate more severe constipation.

Patient Assessment of Constipation Quality of Life Questionnaire (PAC-QOL) will be used to evaluate quality of life. This questionnaire includes a total of 28 items in 4 subscales: worries and concerns (11 items), physical discomfort (4 items), psychosocial discomfort (8 items), and satisfaction (5 items). Higher scores of PAC-QOL indicate more negative effects of constipation on the quality of life.

The stool consistency will be evaluated using the Bristol Stool Scale (BSS), quick and useful indicator of the colonic transit time , a seven-point scale (from 1 to 7), type 1=separate hard lumps, like nuts; 2=sausage shaped but lumpy; 3=like a sausage or snake, but with cracks on its surface; 4=like a sausage or snake, smooth and soft; 5=soft blobs with clear cut edges; 6=ﬂuffy pieces with ragged edges, a mushy stool; 7=water, no solid pieces. While type 1 and 2 indicate hard stool, type 3,4 and 5 show looser (ideal) stool.

In order to gather information regarding the participants' symptoms of constipation, they will be asked to complete a 7-day bowel diary during the treatment period. This diary includes items regarding the frequency of bowel movement, stool consistency, defecation time, feeling of incomplete evacuation, and changes in food and liquid consumption.

Visual Analogue Scale (VAS): This scale is a 10 cm horizontal line. 0 = no pain / bloating / meaning no effect, 10 = unbearable pain / bloating / experiencing

The physical activity levels of the individuals in the last seven days are evaluated under 4 headings (severe activities, moderate activity, walking and sitting). While calculating the total score, the MET-min scores of the patients are obtained by multiplying the duration of activity and frequency of activities (number of days) by the BAT values given to activities (severe activity = 8 MET, moderate activity = 4 MET, walking = 3.3 MET)

It is a 7-item scale that evaluates the perception of the change in the effect of constipation and related complaints on the life of the patient compared to the study. The options on this scale are ''much much better'', ''much better'', 'a little better'', ''no change", ''a little worse'', ''much worse'', ''much much worse''

Doc. Dr.

Hacettepe University

Sarcoma, Soft Tissue

Retroperitoneal Neoplasms

Surgery

Quality of Life

Morbidity

Long Term Morbidity and Quality of Life in Retroperitoneal Sarcomas

Long Term Morbidity and Quality of Life After Multivisceral Resection for Primary Retroperitoneal Soft Tissue Sarcomas: a Prospective Observational Study

Change between baseline and 4 and 12 months scores of the "global health status / QoL" scale in patients primarily treated for localized RSTS, as determined in QLQ-C30 version 3.0.

Evaluate the long term morbidity of aggressive surgical approach to RSTS in terms of renal failure.

Change between baseline and 4 and 12 months scores

Marco Fiore

Attending Surgeon

Fondazione IRCCS Istituto Nazionale dei Tumori, Milano

20 patients randomly assigned to receive 100 U onabotulinumtoxinA reconstituted in 20 ml saline sequentially injected bilaterally into the pubococcygeus, iliococcygeus, coccygeus, obturator internus, and piriformis muscles.

20 patients randomly assigned to receive 20 ml of saline bilaterally into the same pelvic floor muscles.

Myofascial Pain Syndromes

Myofascial Trigger Point Pain

Trigger Point Pain, Myofascial

comparison of OnabotulinumtoxinA with placebo

OnabotulinumtoxinA

comparison of placebo with investigational drug OnabotulinumtoxinA

Placebo

University Case Medical Center

University Hospitals Landerbrook Health Center, Urology

University Hospitals Westlake Health Center, Urology

Injection With OnabotulinumtoxinA (Botox) for the Treatment of Chronic Pelvic Pain

Pelvic Floor Trigger Point Injection With OnabotulinumtoxinA for the Treatment of Severe Myofascial Pelvic Pain (MPP) - A Randomized, Controlled Trial

a 30% reduction of pain and muscular spasm assessed by visual analog scale - VAS

Reduction of pain and muscular spasm assessed at the 1 month visit by visual analog scale - VAS

assessed by validated patient-filled questionnaires

Assessed by clinical complications of therapy (including urinary retention by PVR and other associated complaints)

assessed by pelvic pain scores and pelvic floor pressures

assessed by pelvic pain scores after injection and/or by a change in treatment

assessed by urinary retention defined (PVR >150ml) and other associated complaints

Sangetta Mahajan MD

Assistant Professor & Head Division of Female Pelvic Medicine/Reconstructive Surgery/Obstetrics/Gynecology/Urology and Director of joint fellowship in Female Pelvic Medicine andReconstructive Surgery in the Departments of Obstetrics/Gynecology/Urology

dyspareunia/náusea

The Effects of Abdominal Massage on Functional (Primary) Chronic Constipation

Long Term Morbidity and Quality of Life in Retroperitoneal Sarcomas

Injection With OnabotulinumtoxinA (Botox) for the Treatment of Chronic Pelvic Pain

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