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Investigation of the relationship between rectocele and other pelvic floor disorders
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Abstract
SUMMARY
Background - Objectives: Pelvic floor dysfunction and prolapse are common condition of women past the middle age, with nonspecific clinical symptoms. Many cases of rectocele occurs combine with other pelvic floor disorders. Failure to recognize the complex set of pelvic floor defects leads to most therapy failures. The aim of this study is order to evaluate the correlations between age, number of birth and rectocele, and to define the role of dynamic magnetic resonance defecography in diagnosis.
Methods: Cross-study description. Patients with pelvic floor dysfunction had done clinical examinations and they were indicated
dynamic MR Defecography at University Medical Center, HCM City
by urologist or gynecologist and proctologist.
Results: MR Defecography of 1683 patients was evaluated
from 01/2008 to 6/2012. Most patients are about 40 to 50 years old
with 2 to 3 parity. 1218 patients with incontinence; 1311 patients (77.9%) has rectocele. Prolapse of the posterior compartment
is the most common type of prolapse. Rectocele combines with
more than one pelvic organ prolapse 77.4%; 64.2% of the patients
with anismus had rectocele. There are statistically significant in
the correlation of age, the number of birth with rectocele or pelvic
organ prolapse (OR # 1.04-2.67 and p<0.005). Risk of rectocele
was higher in the patients with pelvic organ prolapse than in the patients without pelvic organ prolapse (p<0.005).
Conclusions: Complex pelvic floor disorders often involve several compartments. Dynamic MR Defecography allows evaluating the both morphological and functional assessment of the pelvic floor, selecting the most appropriate treatment.
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References
1. Maglinte DD, Kelvin FM, Hale DS (1997). Dynamic cystoproctography: a unifying diagnostic approach to pelvic floor and anorectal dysfunction. AJR Am J Roentgenol, 169(3):759–767.
2. Yang A, Mostwin JL, Rosenshein NB (1991). Pelvic floor descent in women: dynamic evaluation with fast MR imaging and cinematic display. Radiology,
179(1):25-33.
3. Healy JC, Halligan S, Reznek RH (1997). Patterns of prolapse in women with symptoms of pelvic floor weakness: assessment with MR imaging, 203:77- 81.
4. Maglinte DD, Kelvin FM, Fitzgerald K (1999). Association of compartment defects in pelvic floor dysfunction. AJR, 172:439-444.
5. Maglinte DD, Kelvin FM, Hale DS (2000). Female pelvic organ prolapse: A comparision of triphasic dynamic MR imaging and triphasic fluoroscopic cystocolpoproctography. AJR 174(1):81-88.
6. Van Dam JH, Ginai AZ, Gosselink MJ (1997). Role of defecography in predicting clinical outcome of rectocele repair. Dis Colon Rectum, 40:201-7.
7. Kruyt RH, Delemarre JB, Doornbos J, Vogel HJ (1991). Normal anorectum: dynamic MR imaging anatomy. Radiology, 179:159–163.
8. Healy JC, Halligan S, Reznek RH (1997). Dynamic MR Imaging Compared with Evacuation Proctography when Evaluating Anorectal Configuration and Pelvic Floor Movement. AJR, 169: 775-779.
9. Fustus E.Roos, Dominik Weishaupt, Simon Wildermuth (2002). Experience of 4 Years with Open MR Defecography: Pictorial Review of Anorectal Anatomy and Disease. RadioGraphics, 22: 817-832
10. Fielding JR (2002). Practical MR Imaging of Female Pelvic Floor Weakness. RadioGraphics, 22:295-304
11. Lamb GM, De Jode MG, Guold SW (2000). Upright dynamic MR defeacating proctography in an open configuration MR system. The British Journal of Radiology, 73:152-155
12. Barbaric ZL, Marumoto AK (2001). MRI of the Perineum and Pelvic Floor. Topic in Magnetic Resonance Imaging 12:83-92.
13. Chu WC, Tam YH, Lam WW (2007). Dynamic MR assessment of the anorectal angle and puborectalis muscle in pediatric patients with anismus: Technique and feasibility. J Magn Reson Imaging, 25:1067-72.
14. Rentsch M, Lenhart M, Paetzel Ch (1999). Dynamic MR imaging defecography: A diagnostic alternative in the assessment of pelvic floor disorders in proctology. Dis Colon Rectum, 44(7):999-1007.
15. Gupta S, Sharma JB (2012). Study of Dynamic MR imaging in diagnosis of pelvic organ prolapse. Arch Gyneco Obstet, 286:953-958
16. Timmons MC, Addition WA (1992). Abdominal sacral colpopexy in 163 women with posthysterecomy vaginal vault prolapse and enterocele. Evoluation of operative techniques. J. Reprod Med, 37:323-327.
17. Symmonds RE, Williams TJ (1981). Posthysterecomy enterocele and vaginal vault prolapse. AmJ Obstet Gynecol, 140:852-859
18. Fernando G. DeAlmeida, Larissa V.Rodríguez, Shlomo Raz. Magnetic Resonance Imaging in the Diagnosis of pelvic floor disorders. Urological Neurology 2002; 28:553-559.
19. Siproudhis L., Dautrème S. (1993). Dyschezia and rectocele-a marriage of convenience? Physiologic evaluation of the rectocele in a group of 52 women
complaining of difficulty in evacuation. Dis Colon Rectum, 36:1030-6.
20. Johansson C, Nilsson BY (1992). Association between rectocele paradoxical sphincter responses. Dis Colon Rectum, 35:503-9.