Jess Anal WORK
It took a bit of effort to get the plug dislodged but the special overnight lube helped to get the toy moving. Jess moaned as her ass started to release its grip on the toy. Sammie, or Sam as her sister called her, pulled the first nine inched of the plug out of Jess' ass then brutally slammed it back in. The four-inch-wide girth of the plug pulled at Jess' anus as the plug moved in and out, making Jess cry out. "Oh god Sam, Please don't stop!" she begged. Jess started to angle her hips towards the thrusting plug, pushing back in rhythm and loving every inch of the anal torment.
Like Jess, Sammie was brought to a number of mind blowing anal orgasms before Jess deemed Sammie's ass fucked well enough for this early in the morning. The duo then picked up their plugs in one hand, held each other's hand, and walked to the bathroom their big pink gapping assholes obvious between their cute little butt cheeks as they walked.
Jess being 18 and Sammie 19, they were both still in high school. They lived with their older sister Amy, who was only 25, since their mother had needed to move for a job and they had wanted to finish school with their friends. Amy had offered to let them live with her under the pretense that the girls continue their anal training even though their mother wouldn't be there to take the 'hand on' approach they all loved. Jess and Sam had enthusiastically agreed and had only needed to be reminded of the terms of agreement a few times, and it might have been on purpose.
In order to stay within the bounds of their agreement with their older sister, the girls had given over control of their ass to each other, knowing that they wouldn't go easy on one another would help them with their anal well being. The enema faucets, by changing a few programmable settings, could be made to only be controllable by certain people. The girls had done just such a thing and now they were at each other's mercy.
Increasing incidence of pouchitis among patients undergoing ileal pouch-anal anastomosis between 1996 and 2018: A population-based Danish cohort study. / Barnes, E.; Allin, K.; Iversen, A. et al.
Methods: Patients with rectal cancer receiving laparoscopic resection between April 2009 and March 2016 were retrospectively analyzed. The association of recurrence with clinicopathological characteristics was evaluated using multivariate analyses.
Results: A total of 405 consecutive patients were included in our study. Within a median follow-up time of 62 months, 77 patients (19.0%) experienced disease recurrence: 10 (2.5%) had locoregional recurrence (LR), 61 (15.1%) had distant metastasis (DM), and 6 (1.5%) developed LR and DM synchronously. The lung was the most common site of metastasis. Multivariate analyses indicated that involved circumferential resection margin (CRM) was the only independent predictor for LR (OR=13.708, 95% CI 3.478-54.026, P
Refractory distal ulcerative colitis (RDUC) is defined as persistence of symptoms caused by endoscopically proven colonic inflammation located at the rectum or left colon despite oral/topical steroids and 5-ASA. RDUC affects a small subset of patients and is associated with chronic disabling symptoms and increased social/medical costs. Moreover, patients with long-standing ulcerative colitis (UC) carry an elevated risk of developing colorectal cancer and colonic mucosa high-grade dysplasia. Alternative medical strategies in steroid refractory disease are unlikely to provide durable remission in all patients, carry potential severe side effects and, as immunosuppressants, the risk of other neoplasms, and may increase the short-term complication rate when surgery is finally required. Restorative proctocolectomy with ileal pouch-anal anastomosis (RP-IPAA) allows the complete removal of the diseased rectum and colon, virtually eliminating the risk of malignant transformation and reestablishing intestinal continuity with continence preservation. Since the introduction of this surgical procedure, morbidity and mortality rates have been drastically reduced. Despite the still notable rate of surgical complications, long-term quality of life assessment has shown excellent results in nearly all patients who have undergone RP-IPAA, comparing well with the general population. Furthermore, when performed for distal UC, RP-IPAA produces similar surgical outcomes with respect to pancolitis. In conclusion, RP-IPAA should always be considered in patients with RDUC, and multidisciplinary counseling should provide patients clear information about the advantages of surgery and possible complications as well as the chance to achieve disease remission with medical therapy. 041b061a72