Rectal intussusception is associated with abnormal levator ani muscle structure and morphometry

Rodrigo, Natassia; Shek, Ka Lai; Dietz, Hans Peter

doi:10.1007/s10151-010-0657-1

Cited by 53 publications

(31 citation statements)

References 30 publications

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“…We now know that the levator ani is commonly damaged in childbirth [5,6], that the use of forceps is the main risk factor [7], and that such tears and overdistension lead to excessive distensibility of the levator hiatus, the largest potential site for herniation in the human body [8]. This damage is associated with symptoms and signs of female pelvic organ prolapse [8,9], with rectal intussusception [10] and with prolapse recurrence after pelvic reconstructive surgery [11][12][13].…”

Section: Piloni Et Al Make An Important Contribution With ''Mrdefecomentioning

confidence: 99%

Imaging in patients with obstructed defecation

Dietz

Cartmill

2013

Tech Coloproctol

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Section: Piloni Et Al Make An Important Contribution With ''Mrdefecomentioning

confidence: 99%

Imaging in patients with obstructed defecation

Dietz

Cartmill

2013

Tech Coloproctol

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“…It is uncertain whether anterior RAI is a precursor of circular RAI. A loose sacral fixation of the rectum associ-ated with an underlying connective disorder may be involved in patients with external rectal prolapse or circular RAI 14,15) . Meantime in patients with anterior RAI, the rectum or the mesorectum may be rather fixed to the sacrum, while only anterior rectal wall may infold during defecation.…”

Section: Discussionmentioning

confidence: 99%

Proctographic findings and symptoms in patients with anterior rectoanal intussusception

Tsunoda

Takahashi

Hayashi

et al. 2017

J Anus Rectum Colon

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Abstract:Objectives: Rectoanal intussusception (RAI) is a common finding on defecography in patients with defecation disorders. This study aimed to compare the proctographic findings and symptoms between patients with anterior RAI and those with circular RAI. Methods: We included 208 patients who were diagnosed as having RAI on defecography. Anorectal function was evaluated using Constipation Scoring System (CSS) and Fecal Incontinence Severity Index (FISI). Results: Twenty-four patients had anterior RAI and 184 had circular RAI. While the anterior intussusception descent or pelvic floor descent was significantly smaller in patients with anterior RAI than those with circular RAI [14.3 vs. 18.5 mm, p=0.004; 12.4 vs. 21.6 mm, p= 0.005], there were no significant differences in incidences of obstructed defecation (OD) and fecal incontinence (FI) between the groups. Sixteen patients with anterior RAI and 137 patients with circular RAI had OD. There was no significant difference in the CSS scores between the groups. Twelve patients with anterior RAI and 108 patients with circular RAI had FI. No significant difference in the FISI scores between the groups. Conclusions: Approximately one tenth of the whole RAI was anterior in location, and symptoms in patients with anterior RAI were similar to those with circular RAI.

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“…In the case of rectal intussusception (RI) the full thickness of the rectal wall invaginates into the anal canal [44] (Fig. 5).…”

Section: Role Of Ultrasound Imaging In the Clinical Work-up Of Patienmentioning

confidence: 99%

“…This may produce a bulge of the posterior vaginal wall, easily mistaken for rectocele or enterocele. Ultrasound studies showed the RI prevalence of 3.9% among urogynecologic patients and 4.3% among patients with obstructed defecation [45, 46]. It is more common in patients with a clinical diagnosis of rectocele or enterocele [45].…”

Section: Role Of Ultrasound Imaging In the Clinical Work-up Of Patienmentioning

confidence: 99%

Ultrasound imaging in urogynecology – state of the art 2016

Bogusiewicz

2016

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The role of ultrasound imaging in urogynecology is not clearly defined. Despite significant developments in visualization techniques and interpretation of images, pelvic ultrasound is still more a tool for research than for clinical practice. Structures of the lower genitourinary tract and pelvic floor can be visualized from different approaches: transperineal, introital, transvaginal, abdominal or endoanal. According to contemporary guidelines and recommendations, the role of ultrasound in urogynecology is limited to the measurement of post-void residue. However, in many instances, including planning and audit of surgical procedures, management of recurrences or complications, ultrasound may be proposed as the initial examination of choice. Ultrasound may be used for assessment of bladder neck mobility before anti-incontinence procedures. On rare occasions it is helpful in recognition of pathologies mimicking vaginal prolapse such as vaginal cyst, urethral diverticula or rectal intussusception. In patients subjected to suburethral slings, causes of surgery failure or postsurgical voiding dysfunctions can be revealed by imaging. Many reports link the location of a tape close to the bladder neck to unfavorable outcomes of sling surgery. Some postoperative complications, such as urinary retention, mesh malposition, hematoma, or urinary tract injury, can be diagnosed by ultrasound. On the other hand, the clinical value of some applications of ultrasound in urogynecology, for example measurement of the bladder wall thickness as a marker of detrusor overactivity, has not been proved.

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Rectal intussusception is associated with abnormal levator ani muscle structure and morphometry

Abstract: Rectal intussusception is not an uncommon finding in urogynaecological patients. While often asymptomatic, it is associated with symptoms of vaginal prolapse, incomplete bowel emptying, vaginal digitation and faecal incontinence, and with abnormal levator ani structure and morphometry.

Cited by 53 publications

References 30 publications

Imaging in patients with obstructed defecation

Imaging in patients with obstructed defecation

Proctographic findings and symptoms in patients with anterior rectoanal intussusception

Ultrasound imaging in urogynecology – state of the art 2016

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