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...

Full description

Bibliographic Details
Main Authors: Cheng Tan, Man Tan, Jing Geng, Jun Tang, Xin Yang
Format: Article
Language:English
Published: BMC 2021-04-01
Series:BMC Women's Health
Subjects:
Online Access:https://doi.org/10.1186/s12905-021-01304-6
_version_ 1818728133230067712
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
work_keys_str_mv AT chengtan rectalvaginalpressuregradientinpatientswithpelvicorganprolapseandsymptomaticrectocele
AT mantan rectalvaginalpressuregradientinpatientswithpelvicorganprolapseandsymptomaticrectocele
AT jinggeng rectalvaginalpressuregradientinpatientswithpelvicorganprolapseandsymptomaticrectocele
AT juntang rectalvaginalpressuregradientinpatientswithpelvicorganprolapseandsymptomaticrectocele
AT xinyang rectalvaginalpressuregradientinpatientswithpelvicorganprolapseandsymptomaticrectocele