Posterior vaginal compartment prolapse and defecatory dysfunction: are they related?

Grimes, Cara L.; Lukacz, Emily S.

doi:10.1007/s00192-011-1629-3

Cited by 33 publications

(12 citation statements)

References 73 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Defecatory dysfunction is a constellation of symptoms that encompasses difficulty with passing stool, excluding anal incontinence. (1, 2) A subset of defecatory dysfunction is obstructed defecation (OD) which can be related to anatomic abnormalities of the posterior compartment including pelvic organ prolapse, perineal descent, intussusception, rectal prolapse, or dysynergic defecation. (3) Complaints of defecatory dysfunction and OD are common among women with pelvic organ prolapse, especially of the posterior compartment.…”

Section: Introductionmentioning

confidence: 99%

What Happens to the Posterior Compartment and Bowel Symptoms After Sacrocolpopexy? Evaluation of 5-Year Outcomes From E-CARE

Grimes¹,

Lukacz²,

Gantz³

et al. 2014

Female Pelvic Medicine &Amp; Reconstructive Surgery

Self Cite

View full text Add to dashboard Cite

OBJECTIVES To describe posterior prolapse (pPOP) and obstructed defecation (OD) symptoms 5 years after open abdominal sacrocolpopexy (ASC). METHODS We grouped Extended Colpopexy And urinary Reduction Efforts (E-CARE) trial participants with baseline and 5-year outcomes into 3 groups using baseline posterior POP-Q points and concomitant posterior repair (PR): No PR (Ap<0); No PR (Ap≥0); and +PR. Posterior colporrhaphy, perineorrhaphy or sacrocolpoperineopexy were included as PR, which was performed at surgeon’s discretion. Outcomes were dichotomized into presence/absence of pPOP (Ap≥0) and OD symptoms (≥2 on one or more questions about digital assistance, excessive straining, or incomplete evacuation). Composite failure was defined by both pPOP and OD symptoms or pPOP reoperation. RESULTS Ninety participants completed baseline and 5 year outcomes or were retreated with mean follow-up of 7.1±1.0 years. Of those with No PR (Ap<0), two women [2/36 (9%)] developed new pPOP with OD symptoms; 1 underwent subsequent PR. Nearly all [23/24 (96%)] with No PR (Ap≥0) demonstrated sustained resolution of pPOP and none underwent PR. Fourteen percent (4/29) of +PR underwent repeat PR within 5 years and 12% had recurrent pPOP. Regardless of PR, OD symptoms improved in all groups after ASC, although OD symptoms were still present in 17-19% at 5 years. CONCLUSION Symptomatic pPOP is common 5 years after ASC regardless of concomitant PR. OD symptoms may improve after ASC regardless of PR. Recurrent pPOP and/or reoperation was highest among those who received concomitant PR at ASC. Further studies identifying criteria for concomitant PR at the time of ASC are warranted.

show abstract

Section: Introductionmentioning

confidence: 99%

What Happens to the Posterior Compartment and Bowel Symptoms After Sacrocolpopexy? Evaluation of 5-Year Outcomes From E-CARE

Grimes¹,

Lukacz²,

Gantz³

et al. 2014

Female Pelvic Medicine &Amp; Reconstructive Surgery

Self Cite

View full text Add to dashboard Cite

show abstract

“…Of note, many patients may present with both defecatory symptoms as well as a posterior vaginal prolapse leading to the assumption that the prolapse is causing the problems. However, the data are conflicting regarding the efficacy of posterior vaginal repair for improving defecatory symptoms and the association is incompletely understood [ 40 , 41 ]. The types of surgical repair for a posterior vaginal prolapse include midline plication (native tissue), site-specific techniques (native tissue), graft/mesh augmentation of the midline or site-specific repairs, transanal repair, ventral rectopexy, and sacral colpopexy, in which the mesh is extended to the distal portion of the posterior vaginal wall and/or perineum.…”

Section: Surgery For Posterior Vaginal Wall Prolapsementioning

confidence: 99%

Summary: 2021 International Consultation on Incontinence Evidence-Based Surgical Pathway for Pelvic Organ Prolapse

Tayrac¹,

Antosh²,

Baeßler³

et al. 2022

JCM

View full text Add to dashboard Cite

(1) Background: There is wide variation in the reported prevalence rates for pelvic organ prolapse (POP). There is also wide variation in the rate at which surgical interventions for pelvic organ prolapse are performed, as well as the type of interventions undertaken. As part of the International Consultation on Incontinence (ICI), our committee was tasked to produce evidence-based pathways for the surgical management of POP, any associated stress urinary incontinence (SUI), and bowel dysfunction. (2) Methods: To enable us to generate such evidence, we undertook a thorough search for the POP surgery-related, English-language scientific literature published up to April 2021. (3) Results: The committee evaluated the literature and made recommendations based on the Oxford grading system. (4) Conclusions: This review serves to provide a summary of the 2021 ICI surgical management of an evidence-based prolapse pathway and outline the evidence used to inform this guidance.

show abstract

“…While modified abdominal sacrocolpopexy results have been reported, data on how these results would compare to traditional transvaginal repair of posterior vaginal wall prolapse is lacking. Data are conflicting regarding the efficacy of posterior vaginal repair on improving defecatory symptoms, and the association is understood incompletely [18,19].…”

Section: Anterior Compartment Surgerymentioning

confidence: 99%

Management of Pelvic Organ Prolapse (POP) and Rectal Prolapse

Hamahata

Akagi

Maeda

et al. 2022

J Anus Rectum Colon

View full text Add to dashboard Cite

Pelvic organ prolapse (POP) is a condition wherein one or more of the organs in the pelvis slip down from their original position and protrude into the vagina. Pelvic organ prolapse surgery has increased in the urogynecological field due to higher aging society. POP patients often suffer from bowel dysfunction, such as difficulty of bowel movements and the need to strain or push on the vagina to have a bowel movement. Rectocele is often treated with the same method used for POP, but sometimes it is treated transanally. In the transabdominal approach, the vagina is divided from the rectum, and the mesh is fixed between the vagina and rectum. On the other hand, rectal prolapse is a condition wherein the rectum slips down from its original position and protrudes from the anus. Like POP surgery, rectal prolapse has been treated laparoscopically. Even though the protruding position is different, both are pelvic conditions, and the concept of treatment is similar. Recently, POP and rectal prolapse have been diagnosed at the same time, and sometimes these diseases have been treated together. In the higher aging society, incidences of POP and rectal prolapse will increase, and both will have greater chance to be treated. Although POP is a urogynecological disease, coloproctologists need to know the bowel dysfunction in order to treat POP.

show abstract

Posterior vaginal compartment prolapse and defecatory dysfunction: are they related?

Cited by 33 publications

References 73 publications

What Happens to the Posterior Compartment and Bowel Symptoms After Sacrocolpopexy? Evaluation of 5-Year Outcomes From E-CARE

What Happens to the Posterior Compartment and Bowel Symptoms After Sacrocolpopexy? Evaluation of 5-Year Outcomes From E-CARE

Summary: 2021 International Consultation on Incontinence Evidence-Based Surgical Pathway for Pelvic Organ Prolapse

Management of Pelvic Organ Prolapse (POP) and Rectal Prolapse

Contact Info

Product

Resources

About