The ‘bother’ of obstructed defecation

P. Alam, R. Guzman Rojas, Ixora Kamisan @ Atan, K. Mann, H. P. Dietz

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objective: To examine the relationship of visual analog scale (VAS) ‘bother’ scores for obstructed defecation (OD) with demographic data, physical examination and sonographic findings of the posterior compartment. Methods: All patients seen at a urogynecology clinic between January and October 2013 were included. Patients were diagnosed with OD if they had any of the following: incomplete bowel emptying, straining with bowel movement or need for digitation. Patients used a VAS to rate OD bother on a scale of 0–10 (0, no bother; 10, worst imaginable bother). For each patient, a comprehensive history was obtained, the International Continence Society Pelvic Organ Prolapse Quantification was performed and four-dimensional translabial ultrasound volumes were recorded on maximal Valsalva maneuver. Linear and multiple regression models were used to correlate bother VAS scores with demographic, clinical and sonographic findings. Results: Among 265 patients included in the analysis, 61% had OD symptoms with a mean VAS bother score of 5.6. OD bother scores were associated with a history of previous prolapse surgery (P = 0.0001), previous hysterectomy (P = 0.0006), descent of the posterior compartment (Bp; P = 0.004) and hiatal dimensions (Pb and Gh + Pb; P = 0.006 and P = 0.004). OD bother was associated with the following sonographic findings: true rectocele (P = 0.01), depth of rectocele (P = 0.04), descent of rectal ampulla (P = 0.02), enterocele (P = 0.03) and rectal intussusception (P < 0.0001). Conclusions: VAS bother scores are associated with both clinical and sonographic measures of posterior compartment descent. Rectal intussusception was most likely to result in highly bothersome symptoms of OD.

Original languageEnglish
Pages (from-to)394-397
Number of pages4
JournalUltrasound in Obstetrics and Gynecology
Volume49
Issue number3
DOIs
Publication statusPublished - 1 Mar 2017
Externally publishedYes

Fingerprint

Defecation
Visual Analog Scale
Rectocele
Intussusception
Demography
Pelvic Organ Prolapse
Valsalva Maneuver
Prolapse
Hernia
Hysterectomy
Physical Examination
Linear Models
History

Keywords

  • obstructed defecation
  • posterior compartment
  • rectal intussusception
  • rectocele
  • translabial ultrasound
  • visual analog scale

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Reproductive Medicine
  • Radiology Nuclear Medicine and imaging
  • Obstetrics and Gynaecology

Cite this

The ‘bother’ of obstructed defecation. / Alam, P.; Guzman Rojas, R.; Kamisan @ Atan, Ixora; Mann, K.; Dietz, H. P.

In: Ultrasound in Obstetrics and Gynecology, Vol. 49, No. 3, 01.03.2017, p. 394-397.

Research output: Contribution to journalArticle

Alam, P. ; Guzman Rojas, R. ; Kamisan @ Atan, Ixora ; Mann, K. ; Dietz, H. P. / The ‘bother’ of obstructed defecation. In: Ultrasound in Obstetrics and Gynecology. 2017 ; Vol. 49, No. 3. pp. 394-397.
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