Improvement in Outlet Obstructive Constipation Symptoms After Vaginal Stent Treatment for Rectocele

Yin, Yitong; Xia, Zhijun; Li, Meng; Qin, Meiying

doi:10.1177/1553350620975616

Cited by 2 publications

(1 citation statement)

References 26 publications

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“…In addition, novel treatment of OD targeting the rectal–vaginal pressure gradient may be established. The use of a vaginal stent, which is designed to apply pressure on the posterior vaginal wall, leads to OD symptom relief [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Rectal–vaginal pressure gradient in patients with pelvic organ prolapse and symptomatic rectocele

Tan

Geng

et al. 2021

BMC Women's Health

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Objective The aim of this study is to examine the relationship between rectal–vaginal pressure and symptomatic rectocele in patients with pelvic organ prolapse (POP). Method Patients with posterior vaginal prolapse staged III or IV in accordance with the POP Quantitation classification method who were scheduled for pelvic floor reconstructive surgery in the years 2016–2019 were included in the study. Rectocele was diagnosed using translabial ultrasound, and obstructed defecation (OD) was diagnosed in accordance with the Roma IV diagnostic criteria. Both rectal and vaginal pressure were measured using peritron manometers at maximum Vasalva. To ensure stability, the test was performed three times with each patient. Results A total of 217 patients were enrolled in this study. True rectocele was diagnosed in 68 patients at a main rectal ampulla depth of 19 mm. Furthermore, 36 patients were diagnosed with OD. Symptomatic rectocele was significantly associated with older age (p < 0.01), a higher OD symptom score (p < 0.001), and a lower grade of apical prolapse (p < 0.001). The rectal–vaginal pressure gradient was higher in patients with symptomatic rectocele (37.4 ± 11.7 cm H2O) compared with patients with asymptomatic rectocele (16.9 ± 8.4 cm H2O, p < 0.001), and patients without rectocele (17.1 ± 9.2 cm H2O, p < 0.001). Conclusion The rectal–vaginal pressure gradient was found to be a risk factor for symptomatic rectocele in patients with POP. A rectal–vaginal pressure gradient of > 27.5 cm H2O was suggested as the cut-off point of the elevated pressure gradient.

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Section: Discussionmentioning

confidence: 99%