Rectal–vaginal pressure gradient in patients with pelvic organ prolapse and symptomatic rectocele
Abstract 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 meth...
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BMC
2021-04-01
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Series: | BMC Women's Health |
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Online Access: | https://doi.org/10.1186/s12905-021-01304-6 |
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author | Cheng Tan Man Tan Jing Geng Jun Tang Xin Yang |
author_facet | Cheng Tan Man Tan Jing Geng Jun Tang Xin Yang |
author_sort | Cheng Tan |
collection | DOAJ |
description | Abstract 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. |
first_indexed | 2024-12-17T22:25:09Z |
format | Article |
id | doaj.art-425d7648fa9345b495ea72b6cb906d11 |
institution | Directory Open Access Journal |
issn | 1472-6874 |
language | English |
last_indexed | 2024-12-17T22:25:09Z |
publishDate | 2021-04-01 |
publisher | BMC |
record_format | Article |
series | BMC Women's Health |
spelling | doaj.art-425d7648fa9345b495ea72b6cb906d112022-12-21T21:30:22ZengBMCBMC Women's Health1472-68742021-04-012111710.1186/s12905-021-01304-6Rectal–vaginal pressure gradient in patients with pelvic organ prolapse and symptomatic rectoceleCheng Tan0Man Tan1Jing Geng2Jun Tang3Xin Yang4Department of Obstetrics and Gyencology, Peking University People’s HospitalDepartment of Obstetrics and Gyencology, Peking University People’s HospitalDepartment of Obstetrics and Gyencology, Peking University People’s HospitalDepartment of Obstetrics and Gyencology, Peking University People’s HospitalDepartment of Obstetrics and Gyencology, Peking University People’s HospitalAbstract 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.https://doi.org/10.1186/s12905-021-01304-6RectoceleObstructed defecationRectal pressureVaginal pressurePelvic organ prolapse |
spellingShingle | Cheng Tan Man Tan Jing Geng Jun Tang Xin Yang Rectal–vaginal pressure gradient in patients with pelvic organ prolapse and symptomatic rectocele BMC Women's Health Rectocele Obstructed defecation Rectal pressure Vaginal pressure Pelvic organ prolapse |
title | Rectal–vaginal pressure gradient in patients with pelvic organ prolapse and symptomatic rectocele |
title_full | Rectal–vaginal pressure gradient in patients with pelvic organ prolapse and symptomatic rectocele |
title_fullStr | Rectal–vaginal pressure gradient in patients with pelvic organ prolapse and symptomatic rectocele |
title_full_unstemmed | Rectal–vaginal pressure gradient in patients with pelvic organ prolapse and symptomatic rectocele |
title_short | Rectal–vaginal pressure gradient in patients with pelvic organ prolapse and symptomatic rectocele |
title_sort | rectal vaginal pressure gradient in patients with pelvic organ prolapse and symptomatic rectocele |
topic | Rectocele Obstructed defecation Rectal pressure Vaginal pressure Pelvic organ prolapse |
url | https://doi.org/10.1186/s12905-021-01304-6 |
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