Rectocele and intussusception: is there any coherence in symptoms or additional pelvic floor disorders?
BACKGROUND
Patients with a rectocele often suffer from such symptoms as obstructed defaecation, urine or stool incontinence and pain. The aim of this study was to assess other concomitant pelvic floor disorders and their influence on pelvic function.


METHODS
Included in the study were 37 female patients with a significant rectocele and defaecation disorder. Medical history and symptoms were analysed in terms of validated functional scores. All patients underwent open magnetic resonance defaecography (MRD) in a sitting position. Imaging was analysed for the presence and size of the rectocele, intussusception and other pelvic floor disorders.


RESULTS
Patients with a higher body mass index tended to have a larger rectocele, whereas age and vaginal birth did not correlate with the size of the rectocele. In 67.5% of the patients with a previously diagnosed rectocele, an intussusception was diagnosed on MRD. This group suffered from significantly worse urine incontinence (p=0.023) and from accessory enteroceles 64%, compared with 17% (p=0.013) for those with a simple rectocele. Patients with higher grade intussusception suffered more frequently from incontinence than from constipation.


CONCLUSIONS
Patients with a symptomatic rectocele frequently have other pelvic floor disorders that significantly influence the pattern of symptoms. Knowledge of all the afflictions is essential for determining the optimal treatment for each individual patient.
Hausammann
R
R
Department of Radiology, University Hospital Zurich, Zurich, Switzerland.
Steffen
T
T
Weishaupt
D
D
Beutner
U
U
Hetzer
F H
FH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003108:Colonic Diseases / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D003672:Defecation / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007443:Intussusception / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D017773:Pelvic Floor / Q000503:physiopathology*; D015995:Prevalence; D020047:Rectocele / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology