Effect of Pelvic Floor Descent on Posterior Pelvic Floor Disorders in Women with Obstructed Defecation Syndrome

Abstract

Background:The relation between age, parity, and posterior pelvic floor disorders involving obstructed defecation syndrome (ODS) is a matter of controversy. This study aimed to determine the effect of pelvic floor descent (PFD) on the prevalence of posterior pelvic floor disorders in women with ODS.Methods: Data for women with ODS, collected in a prospective pelvic floor database, and were assessed retrospectively. Data on demographic variables and defecography were analyzed. PFD during defecation was estimated by the degree of the anorectal junction in relation to the inferior margin of the ischial tuberosity.Results: Of 334 women with ODS, the most frequently detected defecographic abnormalities were rectal intussusception (58%) and rectocele (45%). Regression analysis showed that the presence of rectocele and enterocele was more common in women with increased PFD. A higher incidence of rectocele and enterocele was found in women with excessive PFD (≧ 30 mm) than those without excessive PFD [58% (68/118) vs. 37% (77/209), P < 0.0001; 23% (27/118) vs. 14% (29/209), P = 0.038, respectively]. Increasing size of rectocele was significantly associated with increasing PFD. There were no significant differences in the prevalence of various posterior pelvic floor disorders between nulliparous and parous women. Conclusions:The prevalence of both rectocele and enterocele increased significantly with increasing PFD in women with ODS, but the incidence of rectal intussusception showed no such relationship.