Physiologic and anatomic assessment of patients with rectocele

Yoshioka, Kazuhiko; Matsui, Youichi; Yamada, Osamu; Sakaguchi, Michinobu; Takada, Hideho; Hioki, Koshiro; Yamamoto, Masahiro; Kitada, Mitsuyoshi; Sawaragi, I

doi:10.1007/bf02050355

Cited by 108 publications

(69 citation statements)

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“…rectocele. Our study sup- ports the findings of previous research showing no association between bowel dysfunction and stage of POP [15][16][17] and that there are no major physiological differences by AFT between patients with symptomatic rectocele, asymptomatic rectocele and patients without rectocele [18,19] . Our study could not confirm the finding by Siproudhis et al [20,21] , who reported that constipation in patients with rectocele may be related to higher rectal volumes.…”

Section: Discussionsupporting

confidence: 74%

Anorectal Function Testing and Anal Endosonography in the Diagnostic Work-Up of Patients with Primary Pelvic Organ Prolapse

Groenendijk

Birnie

Boeckxstaens³

et al. 2008

Gynecol Obstet Invest

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Aim: To study the pathophysiology of defecation disorders in patients with primary pelvic organ prolapse (POP) and the diagnostic potential of anorectal function testing (AFT) including endosonography in the work-up of these patients. Methods: 59 Patients were evaluated with a validated questionnaire, clinical examination, AFT and endosonography. Results: Women with POP showed lower squeezing pressure, postponed first sensation and desire, lower capacity and prolonged pudendal nerve terminal latency time compared to healthy controls (all p < 0.01). Manometric findings did not differ significantly between patients with and without constipation. Patients with fecal incontinence had significantly lower resting and squeezing pressures than patients without fecal incontinence and an increased risk of an external sphincter defect (odds ratio = 12.75, 95% confidence interval 2.40–66.67). Although digital rectal examination could quantify absent, decreased and normal squeezing pressure, the positive predictive value for external sphincter defects was low (0.32). Conclusion: AFT indicates the presence of neuromuscular damage of the anorectal region in patients with POP. AFT is not useful in the work-up of patients with POP and constipation, because it fails to discriminate between symptomatic and asymptomatic patients. In cases of fecal incontinence, AFT and endosonography are helpful to distinguish between functional and anatomical problems.

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Section: Discussionsupporting

confidence: 74%

Anorectal Function Testing and Anal Endosonography in the Diagnostic Work-Up of Patients with Primary Pelvic Organ Prolapse

Groenendijk

Birnie

Boeckxstaens³

et al. 2008

Gynecol Obstet Invest

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“…28 Rectocele in females has been associated with a high incidence of perineal descend confirmed by the present report. 29,30 Again, excessive and repeated straining increases the probability of perineal descend and the formation of rectocele.…”

Section: Discussionmentioning

confidence: 99%

Defecographic Findings in Patients with Severe Idiopathic Chronic Constipation

Rafiei

Bayat

Taheri

et al. 2017

Korean J Gastroenterol

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Background/Aims: Chronic constipation is a common gastrointestinal disorder diagnosed using Rome III criteria. Defecography is a radiographic method used to identify anatomic abnormalities of anorectum. The present study aimed to evaluate the defecographic findings in patients with severe idiopathic chronic constipation. Methods: One hundred patients, who complained of severe idiopathic chronic constipation with abnormal balloon expulsion test, underwent defecography after injection of barium. An analysis of radiographs was performed by an expert radiologist for the diagnosis of descending perineum syndrome, rectocele, enterocele, rectal ulcer, rectal prolapse, fecal residue of post defecation, and etc. Then, they were compared between the two sexes. Results: Normal defecography was only observed in two participants. Descending perineum syndrome was the most common abnormality (73.3%). The results showed that rectocele (80.8%) and descending perineum syndrome (69.2%) were most frequent in women. In males, descending perineum syndrome and rectal prolapse were more prevalent (87% and 43.5%, respectively). Compared with men, rectocele and rectal ulcer were more frequently observed in women (p<0.001, and p=0.04, respectively), while men were more affected by descending perineum syndrome (p=0.04). In total, women had a greater incidence of abnormal defecographic findings compared with men (p=0.02). Conclusions: Defecography can be performed to detect anatomic abnormalities in patients with severe idiopathic chronic constipation and abnormal balloon expulsion test. This technique can assist physicians in making the most suitable decision for surgical procedure. (Korean J Gastroenterol 2017;70:39-43)

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“…Rectocele was de¢ned as a bulging of the anterior rectal wall into the lumen of the vagina exceeding 2 cm in size [Shorvon et al, 1989].The size was measured from an extended line of the anal canal to the tip of the rectocele [Yoshioka et al, 1991]. Abnormal pelvic £oor descent was de¢ned as a lowering of the perineal outline exceeding 2 cm at straining [Bremmer et al, 1995].…”

Section: Radiological Examinationmentioning

confidence: 99%