title: Types of pelvic floor dysfunctions in nulliparous, vaginal delivery, and cesarean section female patients with obstructed defecation syndrome identified by echodefecography.
abstract: OBJECTIVE
  This study aims to show pelvic floor dysfunctions in women with obstructed defecation syndrome (ODS), comparing nulliparous to those with vaginal delivery or cesarean section using the echodefecography (ECD).
  
  
  METHODS
  Three hundred seventy female patients with ODS were reviewed retrospectively and were divided in Group I-105 nulliparous, Group II-165 had at least one vaginal delivery, and Group III-comprised of 100 patients delivered only by cesarean section. All patients had been submitted to ECD to identify pelvic floor dysfunctions.
  
  
  RESULTS
  No statistical significance was found between the groups with regard to anorectocele grade. Intussusception was identified in 40% from G I, 55.0% from G II, and 30.0% from G III, with statistical significance between Groups I and II. Intussusception was associated with significant anorectocele in 24.8%, 36.3%, and 18% patients from G I, II, and III, respectively. Anismus was identified in 39.0% from G I, 28.5% from G II, and 60% from G III, with statistical significance between Groups I and III. Anismus was associated with significant anorectocele in 22.8%, 15.7%, and 24% patients from G I, II, and III, respectively. Sigmoidocele/enterocele was identified in 7.6% from G I, 10.9% G II, and was associated with significant rectocele in 3.8% and 7.3% patients from G I and II, respectively.
  
  
  CONCLUSIONS
  The distribution of pelvic floor dysfunctions showed no specific pattern across the groups, suggesting the absence of a correlation between these dysfunctions and vaginal delivery.
authors.affiliation: Department of Surgery, School of Medicine of the Federal University of Ceara, Clinic Hospital, Federal University of Ceara, Av Pontes Vieira, 2551, Fortaleza, Ceará, 60130-241, Brazil. smregadas@hospitalsaocarlos.com.br
authors.forename: Sthela M
authors.initials: SM
authors.lastname: Murad-Regadas
authors.forename: Francisco Sérgio P
authors.initials: FS
authors.lastname: Regadas
authors.forename: Lusmar V
authors.initials: LV
authors.lastname: Rodrigues
authors.forename: Leticia
authors.initials: L
authors.lastname: Oliveira
authors.forename: Rosilma G L
authors.initials: RG
authors.lastname: Barreto
authors.forename: Marcellus H L P
authors.initials: MH
authors.lastname: de Souza
authors.forename: Flavio Roberto S
authors.initials: FR
authors.lastname: Silva
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002585:Cesarean Section; D003248:Constipation / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D019841:Defecography; D005260:Female; D006547:Hernia / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D007443:Intussusception; D008875:Middle Aged; D010298:Parity; D017773:Pelvic Floor / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D011247:Pregnancy; D020047:Rectocele / Q000000981:diagnostic imaging / Q000503:physiopathology; D014463:Ultrasonography