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PubMed1997

Buttock claudication from isolated stenosis of the gluteal artery.

Buttock claudication is usually caused by proximal arterial obstruction in the aorta or the common iliac artery. We report an unusual case of buttock claudication caused by isolated stenosis of the superior gluteal artery diagnosed by angiography. Both physical examination and noninvasive vascular explorations had been unremarkable. Twenty-six months after undergoing treatment by percutaneous transluminal angioplasty, the patient has no symptoms. Buttock claudication related to unilateral stenosis of the superior gluteal artery as observed in this case can be successfully managed by percutaneous transluminal angioplasty.

Aged↗
PubMed1998

Buttockectomy as a limbsaving procedure for locally advanced soft tissue sarcoma of the buttock region.

AIMS: To investigate the effectiveness of a buttockectomy, an unusual surgical procedure for locally advanced soft tissue sarcoma of the buttock region. METHODS: Nine buttockectomy procedures were performed in eight patients for primary (8) or recurrent (1) locally advanced soft tissue sarcoma of the buttocks. Adjuvant external beam radiation therapy was applied within 6 weeks after seven procedures. There were no post-operative complications. RESULTS: No local recurrences occurred in this series. However, distant metastases developed in five patients (63%) after a mean follow-up of 16 months (range 6-25). Overall and disease-free 5-year survival rates were 38 and 25% respectively. CONCLUSION: Buttockectomy with post-operative external beam radiation therapy may be an effective limbsaving treatment option to achieve local tumour control in selected soft tissue sarcomas of the buttock region without an increased surgical and/or radiation-induced morbidity.

Adult↗
PubMed1992

Lumbar support thickness: effect on seated buttock pressure in individuals with and without spinal cord injury.

We compared the effects of different lumbar support thicknesses on seated buttock pressure in individuals with and without spinal cord injury (SCI). Eighteen subjects with SCI (SCI group) and 18 subjects without SCI (control group) were seated on a pressure-sensing transducer incorporated into an adjustable chair. The output was calibrated so that eight pressure intervals (colors) were displayed. The lumbar support thickness was adjusted to 0, 2.5, 5, and 7.5 cm, and the highest and lowest seated buttock pressures were analyzed. External measurements of the hip angle were taken for each lumbar support condition. High reliability of repeated seated test positions was found (intraclass correlation coefficient = .93). The 5- and 7.5-cm-thick lumbar supports caused a decrease in the highest pressure areas in the control group, but no change in the SCI group. The hip angle was increased with each increment in lumbar support thickness in both groups, but the SCI group's hip angle was consistently less than that of the control group for each lumbar support condition. The results of this study suggest that in individuals with chronic paralysis (greater than or equal to 3 years), the use of a wheelchair lumbar support has a negligible effect on seated buttock pressure.

Adult↗
PubMed1992

Massive extravasation of traumatically ruptured buttock silicone prosthesis.

Although requests for gluteal implants are unusual in the United States, the use of silicone implants for buttock cosmesis has been described. Complications of this procedure have rarely been reported. There are no reports of long-term follow-up in these patients. This report describes the traumatic rupture of a silicone buttock implant nine years after initial surgical placement. Massive silicone extravasation and migration, along with silicone granuloma formation, occurred. The contralateral implant remained intact, functional, and cosmetically acceptable. The surgical approach and repair of this injury is outlined and discussed. We conclude that early surgical treatment of extravasation injuries is needed and that buttock reconstruction with implants can be useful, but close follow-up is needed. We also suggest there is a need to evaluate alternative materials for use in this procedure.

Adult↗
PubMed1988

Penetrating trauma to the buttock.

Penetrating trauma to the buttock is an injury with potential impact on multiple body systems. The purpose of this study was to review our experience with penetrating trauma to the buttock, to establish the frequency of system injury and related morbidity and mortality, and to make recommendations for the evaluation and management of these injuries. Among the 56 system injuries, soft tissue injuries predominated. Of the 25 operative procedures done, eight were for wound care and debridement and seven for rectal injuries; three were orthopedic, two vascular, three genitourinary, and one neurosurgical. One patient had examination under anesthesia, and one had laparotomy for missile trajectory. There were no deaths in this series. Morbidity consisted of nerve injury/defect in three patients, stroke in one patient, and impotence in one. An understanding of the systems at risk in penetrating buttock trauma is necessary for prompt multisystem work-up.

Adult↗
PubMed2001

Buttock placement of the implantable pulse generator: a new implantation technique for sacral neuromodulation--a multicenter study.

OBJECTIVE: In the standard operation procedure for sacral neuromodulation, the implantable pulse generator (IPG) is implanted in a subcutaneous pocket at the lower part of the anterior abdominal wall. This procedure requires a long operation time and three incisions. With the IPG in the abdominal wall, some patients complain of displacement or pain at the IPG site postoperatively. By modifying the technique of placement of the IPG, these disadvantages are overcome. METHODS: Between August 1999 and July 2000, 39 patients underwent a buttock implant of the IPG. In 2 of these patients the position of the IPG was changed from abdominal region to the buttock. During follow-up, complications concerning the operation and location of the IPG were compared to the published literature. RESULTS: Operation time is reduced in all patients by approximately 1 h. No repositioning of the patient is required during surgery. Only a short subcutaneous tunnel is required to connect the lead to the IPG. Pain at the level of the IPG was noted in 10% of the patients, which needed no further treatment. No infections were seen and the IPG did not displace postoperatively. CONCLUSION: Buttock placement of the IPG in sacral nerve stimulation leads to shorter operation time; only two incisions are needed instead of three and a shorter subcutaneous tunnel is needed. Using this technique there are less complications and a lower re-operation rate.

Adult↗
PubMed1994

Competitive reverse transcription-polymerase chain reaction analysis indicates that levels of aromatase cytochrome P450 transcripts in adipose tissue of buttocks, thighs, and abdomen of women increase with advancing age.

Circulating androstenedione is converted to estrone in adipose tissue, which is the principal site of estrogen biosynthesis in postmenopausal women. This reaction is catalyzed by a specific form of cytochrome P450 (P450arom; the product of the CYP19 gene). The fractional conversion of plasma androstenedione to estrone as well as the specific activity of aromatase in adipose stromal cells were previously shown to increase with advancing age. To determine whether this positive effect of aging on estrogen biosynthesis is due to an alteration in tissue levels of P450arom transcripts, we quantified P450arom mRNA levels in sc fat biopsy samples (n = 33) from buttocks, thighs, and abdomen of 11 women who ranged in age from 23-61 yr. Competitive polymerase chain reaction linked to reverse transcription was used to quantify P450arom transcripts in total RNA that was isolated from sc fat obtained by needle aspiration. In each sample, primer extension and coamplification of a rat P450arom cRNA as an internal standard were used to control possible differences in amplification efficiencies between samples. The results demonstrate that with advancing age in women, there is a progressive and statistically significant increase in adipose tissue P450arom transcript levels (normalized to total RNA content) in buttocks, thighs, and abdomen (correlation coefficients: r = 0.704, 0.854, and 0.933, respectively). The levels of transcripts observed in the older subjects reach 2- to 4-fold greater than those observed in the young women. Adipose tissue P450arom transcript levels were highest in the buttocks, followed by the thighs, and lowest in the abdomen. This increase in P450arom transcript levels is likely to be a major factor contributing to the increased extragonadal estrogen biosynthesis in elderly women.

Abdomen↗
PubMed2006

Absence of buttock claudication following stent-graft coverage of the hypogastric artery without coil embolization in endovascular aneurysm repair.

PURPOSE: To evaluate the safety and efficacy of stent-graft coverage of the hypogastric artery origin without coil embolization during endovascular treatment of aortoiliac or iliac aneurysms. METHODS: A retrospective study was conducted of patients who underwent endovascular aneurysm repair with endograft coverage of the hypogastric artery between September 2001 and September 2005. Among the 88 patients who underwent EVAR during the study period, 21 patients (19 men; mean age 77+/-6 years, range 67-86) had unilateral hypogastric artery coverage without coil embolization. Aneurysmal arteries included 11 aortoiliac, 8 isolated common iliac arteries (CIA), and 2 isolated hypogastric arteries. Preoperative AAA size was a mean 57 mm (range 46-73), and mean CIA aneurysm diameter was 36 mm (range 17-50). All covered hypogastric arteries were patent prior to the procedure. The stent-grafts implanted were 10 Excluder, 10 AneuRx, and 1 Zenith. Clinical outcome focused on mortality and morbidity, including the occurrence and duration of new-onset buttock claudication, which was further correlated with superior gluteal and profunda femoris artery patency. RESULTS: Immediate seal was achieved in all patients. Mean follow-up was 16 months (range 1-54). No type I endoleaks developed from the aortic or external iliac artery, and no type II endoleaks were found from the origin of the hypogastric artery. New-onset buttock claudication occurred in 2 (9.5%) patients, but resolved in both within 4 months. No additional secondary procedures, aneurysm rupture, or aneurysm-related death occurred. CONCLUSION: Stent-graft coverage of the orifice of the hypogastric artery without coil embolization is a safe and effective adjunct during the treatment of aortoiliac or iliac aneurysm, with a low incidence of buttock claudication.

Aged↗
PubMed2003

Extraskeletal osteochondroma of the buttock.

Osteochondromas are common and typically arise from the metaphyseal ends of long bones. An osteochondral neoplasm of the soft tissue, which is a lesion of uncertain pathogenesis, is uncommon and usually arises from the synovial tissue in joints and tendon sheaths. Rarely, extraskeletal osteochondromas also arise outside of synovial compartments. Most of the reported cases were presented in the hands and feet, especially in the fingers. Here we describe a 44-yr-old female patient who presented with a pain in the left buttock. A well-defined osseous mass was detected in the buttock. It consisted of sharply demarcated, mature hyaline cartilage that was covered with a fibrous capsule, which changed gradually into cancellous bone, more pronouncedly at the center. The diagnosis of an extraskeletal osteochondroma should be considered when a discrete, ossified mass is localized in the soft tissues. A case of pathologically proven extraskeletal osteochondroma of the buttock is presented with a literature review, magnetic resonance imaging, and radiological findings.

Accidental Falls↗
PubMed2000

[Tumoral mycetoma of the buttock].

BACKGROUND: Mycetomas are actinomycosic or fungal infections where the infectious agent produces grains. We report an atypical case of fungal mycetoma presenting as a tumoral formation on the buttock. CASE REPORT: A 56-year-old unemployed man from the Diourbel region of central Senegal consulted in February 1997 for a fistulalized tumor of the right buttock which had developed spontaneously and progressed for 5 years. The patient's general health remained satisfactory. Physical examination showed a voluminous 25 cm tumefaction extending from the right buttock to the perineum. The tumor showed a few areas of fistualization which discharged black grains under pressure. There was a 1.5 cm right inguinal node which did not appear to be inflammatory. The remainder of the physical examination was normal. Pathology reported inflammatory connective tissue surrounding a brownish polycyclic grain composed of spores and mycele filaments. The diagnosis of fungal mycetoma was retained and surgical excision under general anesthesia was performed. DISCUSSION: This is an atypical case of fungal mycetoma because of its tumoral form and gluteal localization. The differential diagnosis was cutaneous neurofibroma, myoma, or Darier-Ferrand dermatofibrosarcoma. The frequency of extrapodal red grain mycetomas has been pointed out by several authors from Senegal, but extrapodal black grain forms as seen in our case are more exceptional.

Buttocks↗
PubMed2000

Fat transplantation to the buttocks and legs for aesthetic enhancement or correction of deformities: long-term results of large volumes of fat transplant.

BACKGROUND: A comprehensive review of the history of free fat transplantation reveals that since 1893 when Neuber used small pearls of fat taken from the arm to fill out depressed facial scars after trauma and underlying bone loss, free fat graft has been used with success in facial surgery, brain and nervous system surgery, various orthopedic uses, general surgery, craniofacial surgery, and cosmetic surgery. OBJECTIVE: To present the author's hypothesis that a fat graft in cosmetic surgery responds like other kinds of tissue grafts. This article was written as a result of the author's search for a way to avoid the most common complications of doing a buttock or leg augmentation with silicone prostheses and to find a better surgical procedure that is simpler, complementary with liposuction, and better able to deal with subtle body irregularities that do not justify a large and complicated procedure. METHODS: Over a period of 6.5 years, a total of 1350 liposculptures were performed. Eight hundred and seventy-nine patients had buttock augmentation. One patient had facial hemiatrophy and her face was treated twice with fat grafts. Four hundred and seventy patients had fat grafted onto their ankles and their legs for cosmetic reasons. One patient with polio sequelae and one male patient with agenesia of the gemellus muscles over his left leg were treated. The patients selected were not obese, but had moderate to severe lipodystrophy. The patients ranged in age from 18 to 65 years. RESULTS: The results of the buttock augmentations showed that there was a 0.5-1.0 cm reduction at 2 months. This persisted until the sixth month and until years later. These findings were seen in patients that had 3-5 kg less body weight after surgery than before or had 3-5 L of fat removed from their bodies. Patients who underwent ankle or leg augmentation experienced a 0.5 cm loss in diameter over the treated areas after the 1.5-month postoperative period. No more volume was lost after that. The areas kept the same parameters until the sixth month and also into later follow-ups. The few complications that our patients experienced appeared between days 2 and 15. The complications of 6.5 years occurred in 14 patients (1.037%). One case of erysipelas appeared on the 10th postoperative day. This patient reported that she was riding a bicycle and had a scratch over the left ankle, producing an infection with edema, erythema, and pain. Twelve patients got skin vesicles because of contact with micropore over the skin of the ankles. We treated those patients with local antibiotics, obtaining healing of the skin in about 5 days, with dryness and absence of the vesicles. No damage to the graft was observed. CONCLUSION: The hypothesis that applied fat grafts are real grafts was demonstrated. Not only are the grafts real, they are able to live and persist with the patients, growing if the patient gained weight over the gluteus area, and not losing circumference when reducing weight.

Adipose Tissue↗
PubMedDate not supplied

[Buttock mass and malignant sciatic nerve tumor].

Malignant peripheral nerve sheath tumors (MPNST) are rare. We report a case of a MPNST of the proximal sciatic nerve in the thigh, unassociated with pre-existing type 1 neurofibromatosis or history of radiation therapy. A 71-year-old man had a 6 month history of constant, severe, burning pain affecting the sole of the left foot. One month after the onset, the pain radiated to the left calf, posterior aspect of the thigh and buttock, and distal leg weakness followed. Three months prior to admission, the patient developed a large and painful mass in the buttock, that occupied the entire left gluteal region on examination. There was severe weakness of ankle and toe dorsiflexion and plantarflexion, decreased sensation on the lateral and posterior aspect of the left leg as well as on the dorsal and plantar surfaces of the foot, and absent ankle jerk. EMG showed denervation and motor unit loss in the short head of biceps femoris and muscles supplied by tibial and peroneal nerves on the left side. Magnetic resonance imaging revealed a 10-cm enhancing mass of the left sciatic nerve from the upper thigh to the greater sciatic notch. In surgery, a large MPNST with a high Ki67 labeling index (> 60 %) was subtotally removed from the sciatic nerve, and adjuvant radiation therapy was administered. In the ensuing months the tumor invaded the entire pelvic region. A high sciatic malignant tumor can present with a rapidly growing buttock mass and unilateral, neuropathic foot pain imitating the tarsal tunnel syndrome.

Aged↗
PubMed1992

A comparison of the ultraviolet B-induced erythemal response of back and buttock skin.

Thirty-six subjects (dermatology patients and normal volunteers) were phototested on back and buttock skin to determine their erythemal response to a geometrically increasing series of doses of ultraviolet B (UVB) radiation. The minimal erythema doses (MED) were recorded at 24 h post-irradiation and dose-response curves were constructed. A significant difference in MED was found between the 2 sites, with a higher value for buttock skin (median 38 mJ/cm2) than for the back (median 25 mJ/cm2). The slopes of response for the 2 sites were, however, found to be comparable, and there was no correlation between the slope of dose response and sun-reactive skin type at either site. Buttock skin, representing the constitutional skin colour, may provide a useful site for phototesting, especially in otherwise tanned individuals, providing that full dose-response curves are analysed.

Adolescent↗
PubMed1984

[Chromomycosis of the buttocks].

We report a case of chromomycosis involving buttocks in a 63 years old white male patient, who was living temporaly in several tropical areas of Argentine, due to professional reasons. The lesion had arisen 28 years ago, located in his right buttock. Clinical examination showed a large, erythematous and violaceus plaque, with atrophic center and peripheric warty nodules. Diagnosis was established on histologic and mycologic examination. Fonsecaea pedrosoi was isolated as the ethiologic agent. Treatment was instituted with oral 5-fluorocytosine and topic 5-fluorouracil with good evolution. We found our case interesting for several reasons: A) Chromomycosis is an unfrequent disease in Argentine. B) Buttock involvement is unusual. C) Clinically the patient simulated lupus vulgaris; this situation was a cause of delayed correct diagnosis and treatment.

Buttocks↗
PubMed1997

Sciatica as the first manifestation of a leiomyosarcoma of the buttock.

We report the case of a 22-year-old woman who was admitted for inflammatory right-sided sciatica with a decline in general health. Laboratory tests showed severe inflammation. Ultrasonography and computed tomography of the buttock and pelvis demonstrated a large tumor in the deep muscles of the right buttock, with an intrapelvic component that displaced the pelvic organs without invading them. Histologic examination of a biopsy specimen taken via the buttock established the diagnosis of leiomyosarcoma. Surgery by a pelvic approach allowed partial resection of the tumor, which was seen to invade the sciatic nerve. Radiation therapy was given. Six months later the residual tumor was considerably larger and the patient's general health had deteriorated further. Leiomyosarcomas are rare tumors whose diagnosis rests on histologic examination of biopsy or surgical specimens. The treatment is surgical. Recurrences are seen in 40 to 60% of cases, and metastases in 27 to 60%. The place of radiation therapy and chemotherapy in the treatment of leiomyosarcoma remains unclear.

Adult↗
PubMed1998

[Buttock claudication as the dominant symptom of atherosclerosis: a case report].

Buttock claudication is rather rare symptom of atherosclerosis. Authors presented a case of 61 year old patient in whom buttock claudication was only one symptom. The patient was surgically treated (endarterectomy of iliac internal artery with ilico-femoral bypass) with excellent result. Authors pointed out necessity of restoration of blood flow through internal iliac artery as a prevention or treatment in buttock claudication.

Arteriosclerosis↗
PubMedDate not supplied

Circular lipectomy with lateral thigh-buttock lift.

Patients with body contour deformities amongst the challenges that plastic surgeons most frequently face. Through the years, many surgical procedures have been developed that attempt to solve many forms of body contour deformities while optimizing the number of surgical stages within safety limits. In one stage, circular lipectomy with lateral thigh and buttock lift and trochanteric liposuction corrects deformities of the abdomen, the lateral thighs, the buttocks, the supra-gluteal area, the lateral supra-gluteal area, leaving only one circular scar that can be covered with a thong. It is performed under epidural anesthesia, requires one or two units of autologous blood, one night in a hospital, and two or three weeks off work. Thirty-nine patients were operated on without any major complications. Results were consistently good and superior to patients' expectations.

Abdomen↗
PubMed2004

Correction of buttock ptosis with anchoring deepithelialized skin flaps.

A new technique for correction of a buttock ptosis resulting from a degloving injury is presented. With this technique, the deepithelialized crescent-like zone in lateral thigh redundancy anchored to gluteal fascia through three separate incisions as used for creation of a new gluteal crease. The patient's satisfaction was good with long-term follow-up evaluation. Infragluteal fold reconstruction is achieved by reconstruction of the buttock's sustaining apparel through deepithelialized skin flaps anchored to deep gluteal fascia.

Adipose Tissue↗