The prevalence of abnormal posterior compartment anatomy and its association with obstructed defecation symptoms in urogynecological patients

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dc.contributor.authorGuzmán Rojas, Rodrigo
dc.contributor.authorKamisan, Ixora
dc.contributor.authorShek, Ka Lai
dc.contributor.authorDietz, Hans
dc.date.accessioned2017-05-16T14:38:35Z
dc.date.available2017-05-16T14:38:35Z
dc.date.issued2016
dc.description.abstractINTRODUCTION AND HYPOTHESIS: Symptoms of obstructive defecation (OD) are common in women. Transperineal ultrasound (TPUS) has been used for the evaluation of defecatory disorders. The aim of our study was to determine the overall prevalence of anatomical abnormalities of the posterior compartment and their correlations with OD in women seen in a tertiary urogynecology clinic. METHODS: This is a retrospective study on 750 women seen at a tertiary urogynecological unit who had undergone a standardized interview, clinical examination, and 4D TPUS. Univariate and multivariate logistic regression analyses were undertaken to study the association between examination findings and symptoms of OD. This study was approved by the local human research ethics committee (Nepean Blue Mountains Local Health District Human Research Ethics Committee, IRB approval no. 13-16). RESULTS: The datasets of 719 women were analyzed. Mean age was 56.1 (18.4-87.6) years. Ninety-seven patients (13 %) reported fecal incontinence, 190 (26 %) constipation, and 461 (64 %) symptoms of OD. On examination, 405 women (56 %) were diagnosed with significant posterior compartment prolapse (POP-Q ≥ stage 2), which was associated with symptoms of OD (p < 0.0001). On ultrasound, 103 (14 %) patients had an enterocele, 382 (53 %) a true rectocele and 31 (4.3 %) had rectal intussusception. On multivariate analysis true rectocele (p = 0.003) and rectal intussusception (p = 0.004) remained significantly associated with symptoms of OD. CONCLUSION: Both symptoms of OD and anatomical abnormalities of the posterior compartment are highly prevalent in urogynecological patients. Ultrasound findings of a true rectocele and rectal intussusception are significantly associated with obstructed defecation.
dc.format.extent6
dc.identifier.citationGuzman Rojas R, Kamisan Atan I, Shek KL, Dietz HP. The prevalence of abnormal posterior compartment anatomy and its association with obstructed defecation symptoms in urogynecological patients. Int Urogynecol J. 2016 Jun;27(6):939-44.
dc.identifier.urihttp://hdl.handle.net/11447/1260
dc.identifier.urihttp://dx.doi.org/10.1007/s00192-015-2914-3
dc.language.isoen_US
dc.publisherSpringer
dc.subjectEnterocele
dc.subjectIntussusception
dc.subjectPosterior compartment
dc.subjectRectocele
dc.subjectTransperineal ultrasound
dc.titleThe prevalence of abnormal posterior compartment anatomy and its association with obstructed defecation symptoms in urogynecological patients
dc.typeArtículo

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