This textbook addresses the best way of evaluating patients with rectal prolapse, the underlying pathophysiology, the different surgical approaches, the expected functional results after surgery and the management of complex clinical conditions associated with this condition. It is an essential book that attempts to draw together material that could be of vital importance to surgeons around the world. The pathophysiology of rectal prolapse is still uncertain and its clinical and instrumental diagnostic assessment needs to be clarified.

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.

Reconstructive Colorectal and Anal Surgery presents a didactic discussion of complex colonic, rectal, anal, and perineal problems which require reoperative surgery. The book provides a very practical description of the management towards these problems including preoperative investigation, postoperative follow-up and detailed operative approach. The text is aimed at being relatively didactic with an algorithm approach to these complicated cases using operative photographs and composite explanatory line drawings which are complemented by ‘how-to’ guides in all cases describing the operative technical tips and pitfalls from experienced world-renowned commentators. Given the rapid change in techniques over the last 10 years newer procedures will be incorporated. This book will be essential reading for all colorectal surgeons and trainees, general surgeons and trainees, gynecologists as well as specialist nurses in the OR room.

The foundation needed for the understanding and hence the treatment of a disease is a knowledge of the natural morphology and physiology of the affected organ and the system to which it belongs. In describing the anatomy of the pelvis and its organs in relation to medical practice, attention will be paid to defensive, reproduc tive, metabolic and excretory systems as well as to describing physical features and surgical approaches. The disposition of the pelvic organs in the body framework merits particular attention. The pelvis and its organs undergo considerable sexual differentiation, the functions of those with opening and closing mechanisms require training, and the pelvis is the keystone of the lower limbs and the spine. Disorders of pelvic organs cause distressing illnesses. Deliberate limitation of the scope of this volume excludes description of the anatomic foundations of pregnancy, childbirth and the puerperium. These will be dealt with in a separate volume. Not only are the anatomic foundations of medical practice the starting point of the account, they are also constantly kept in view. The illustrations and text combine to provide a visual synopsis. The illustrations are based on original dissections and are drawn true to scale as far as possible. No use has been made of special means of visualizing organs or their vasculature, such as roentgenography, computed tomog raphy, arteriography, phlebography, lymphography and sonography. Technical stan dards change rapidly and individual findings inevitably receive overmuch attention. Relevant publications are named in the list of references.

A definitive, accessible, and reliable resource which provides a solid foundation of the knowledge and basic science needed to hone all of the core surgical skills used in surgical settings. Presented in a clear and accessible way it addresses the cross-specialty aspects of surgery applicable to all trainees.

For over a century, the development of the perineum has received ample attention because of the striking complexity of its formation and malformation. In the prolonged disputes at this subject, normal and abnormal development became intricately interwoven and ideas about the normal process were often directed by the anomalies. The unexpected results from an investigation into hereditary congenital anorectal malformations of pig embryos demonstrated the weakness of such interpretations and constructions and underlined the need for a new inquiry into the normal development of the area in human embryos. They showed that although data from malformations may offer extra information about the normal development of the area, great care has to be taken in using that information for the reconstruction of its normal development which should be based first and foremost on the observation of the evolving microscopic anatomy of the region. To avoid the inconsistencies caused by fragmented research in the past, such an investigation should comprise the whole structure of the region from its incipience to birth. The present study offers such a survey. It contradicts current opinion on major developmental events and gives new insights into the origin of the urinary bladder, the subdivision of the cloaca, the transformation of the cloacal mantle into the erectile, fascial and muscular structures of the female and male perineum, and also corrects existing ideas about the formation of the vagina, urethra and vestibulum in the female and the urethra, penis and scrotum in the male. These new findings will be indispensable in unravelling the pathogenesis of challenging perineal malformations. (not yet copy edited, March 16,2004)