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

Rodrigo Guzman Rojas, Ixora Kamisan @ Atan, Ka Lai Shek, Hans Peter Dietz

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Introduction 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.

Original languageEnglish
Pages (from-to)1-6
Number of pages6
JournalInternational Urogynecology Journal and Pelvic Floor Dysfunction
DOIs
Publication statusAccepted/In press - 15 Dec 2015

Fingerprint

Defecation
Anatomy
Rectocele
Intussusception
Research Ethics Committees
Fecal Incontinence
Prolapse
Constipation
Hernia
Multivariate Analysis
Retrospective Studies
Logistic Models
Regression Analysis
Interviews
Health

Keywords

  • Enterocele
  • Intussusception
  • Posterior compartment
  • Rectocele
  • Transperineal ultrasound

ASJC Scopus subject areas

  • Urology
  • Obstetrics and Gynaecology

Cite this

@article{c64e676ade9a4872878fc0438d979bf9,
title = "The prevalence of abnormal posterior compartment anatomy and its association with obstructed defecation symptoms in urogynecological patients",
abstract = "Introduction 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.",
keywords = "Enterocele, Intussusception, Posterior compartment, Rectocele, Transperineal ultrasound",
author = "{Guzman Rojas}, Rodrigo and {Kamisan @ Atan}, Ixora and Shek, {Ka Lai} and Dietz, {Hans Peter}",
year = "2015",
month = "12",
day = "15",
doi = "10.1007/s00192-015-2914-3",
language = "English",
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journal = "International Urogynecology Journal and Pelvic Floor Dysfunction",
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T1 - The prevalence of abnormal posterior compartment anatomy and its association with obstructed defecation symptoms in urogynecological patients

AU - Guzman Rojas, Rodrigo

AU - Kamisan @ Atan, Ixora

AU - Shek, Ka Lai

AU - Dietz, Hans Peter

PY - 2015/12/15

Y1 - 2015/12/15

N2 - Introduction 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.

AB - Introduction 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.

KW - Enterocele

KW - Intussusception

KW - Posterior compartment

KW - Rectocele

KW - Transperineal ultrasound

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