title: Association of compartment defects in anorectal and pelvic floor dysfunction with female outlet obstruction constipation (OOC) by dynamic MR defecography.
abstract: OBJECTIVE
  Chronic constipation affects more than 17% of the global population worldwide, and up to 50% of patients were outlet obstruction constipation (OOC). Women and the elderly are most likely to be affected, due to female-specific risk factors, such as menopause, parity and multiparity. The aim of our study was to investigate the association of compartment defects in anorectal and pelvic floor dysfunction with female outlet obstruction constipation (OOC) by MR defecography.
  
  
  METHODS
  Fifty-six consecutive women diagnosed with outlet obstruction constipation from October 2009 to July 2011 were included. They were categorized into the following groups: anorectal disorder only group (27 patients) and anorectal disorder plus multi-compartment pelvic disorder group (29 patients). Relevant measurements were taken at rest, during squeezing and straining.
  
  
  RESULTS
  Anismus was significantly more common in the anorectal disorder group compared to the multi-compartment pelvic disorder group. Conversely, rectocele, rectal prolapse, and descending perineum were significantly more common in the multi-compartment pelvic disorder group compared to the anorectal disorder group. Of the total 56 OOC patients, 34 (60.7%) exhibited anismus and 38 (67.9%) rectocele. Among the anismus patients, there were 8 patients (23.5%) with combined cystocele, and 6 patients (17.6%) with combined vaginal/cervical prolapse. Among the rectocele patients, there were 23 patients (60.5%) with combined cystocele and 18 patients (47.4%) with combined vaginal/cervical prolapse. With respect to anorectal defects, 13 anismus patients (38.2%) were with signal posterior pelvic defects, 4 rectocele patients (10.5%) presented with signal posterior pelvic defects.
  
  
  CONCLUSIONS
  Inadequate defecatory propulsion due to outlet obstruction constipation is often associated with multi-compartment pelvic floor disorders, whereas not about dyssynergic defecation.
authors.affiliation: Department of Radiology, Beijing Chaoyang Hospital, Affiliated to Capital Medical University, Beijing, China. jiangtao68@yeah.net.
authors.forename: M
authors.initials: M
authors.lastname: Li
authors.forename: T
authors.initials: T
authors.lastname: Jiang
authors.forename: P
authors.initials: P
authors.lastname: Peng
authors.forename: X-Q
authors.initials: XQ
authors.lastname: Yang
authors.forename: W-C
authors.initials: WC
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000473:pathology* / Q000503:physiopathology; D003248:Constipation / Q000175:diagnosis* / Q000503:physiopathology; D019841:Defecography / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D017773:Pelvic Floor / Q000473:pathology* / Q000503:physiopathology; D020047:Rectocele / Q000175:diagnosis / Q000503:physiopathology; D012007:Rectum / Q000473:pathology* / Q000503:physiopathology