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. 2010 Dec;26(6):395-401.
doi: 10.3393/jksc.2010.26.6.395. Epub 2010 Dec 31.

Clinical Significance of Perineal Descent in Pelvic Outlet Obstruction Diagnosed by using Defecography

Hyun Nam Baek  1 , Yong Hee Hwang, Yong Hwan Jung
Affiliations

Clinical Significance of Perineal Descent in Pelvic Outlet Obstruction Diagnosed by using Defecography

Hyun Nam Baek et al. J Korean Soc Coloproctol. 2010 Dec.

Abstract

Purpose: The aim of this study was to evaluate the clinical significance of perineal descent (PD) in pelvic outlet obstruction patients diagnosed by using defecography.

Methods: One hundred thirty-six patients with pelvic outlet obstruction (POO; median age 49 years) had more than one biofeedback session after defecography. Demographic finding, clinical bowel symptoms and anorectal physiological studies were compared for PD at rest and PD with dynamic changes.

Results: Age (r = 0.33; P < 0.001), rectocele diameter (r = 0.31; P < 0.01), symptoms of incontinence (P < 0.05) and number of vaginal deliveries (r = 0.46; P < 0.001) were correlated with increased fixed PD. However, the female gender (P < 0.005), rectal intussusceptions (P < 0.05), negative non-relaxing puborectalis syndrome (P < 0.00005) and rectocele (P < 0.0005) were correlated with increased dynamic PD. Duration of symptoms, number of bowel movements, history of pelvic surgery and difficult defecation were not related with PD. There was no significant correlation between fixed and dynamic PD and success of biofeedback therapy.

Conclusion: Age, vaginal delivery and diameter of the rectocele are associated with increased fixed PD. Female gender, rectal intussusceptions and a rectocele are correlated with increased dynamic PD. Biofeedback is an effective option for POO regardless of severity of PD.

Keywords: Biofeedback; Pelvic outlet obstruction; Perineal descent.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
Age and fixed perineal descent (PD; r = 0.33, P < 0.001).
Fig. 2
Fig. 2
Vaginal delivery and fixed perineal descent (PD; r = 0.46, P < 0.001).
Fig. 3
Fig. 3
Rest angle and fixed perineal descent (PD; r = 0.67, P < 0.001).
Fig. 4
Fig. 4
Push angle and dynamic perineal descent (PD; r = 0.33, P < 0.001).
See this image and copyright information in PMC

References

    1. Porter NH. A physiological study of the pelvic floor in rectal prolapse. Ann R Coll Surg Engl. 1962;31:379–404. - PMC - PubMed
    1. Parks AG, Porter NH, Hardcastle J. The syndrome of the descending perineum. Proc R Soc Med. 1966;59:477–482. - PMC - PubMed
    1. Henry MM, Parks AG, Swash M. The pelvic floor musculature in the descending perineum syndrome. Br J Surg. 1982;69:470–472. - PubMed
    1. Bartolo DC, Read NW, Jarratt JA, Read MG, Donnelly TC, Johnson AG. Differences in anal sphincter function and clinical presentation in patients with pelvic floor descent. Gastroenterology. 1983;85:68–75. - PubMed
    1. Snooks SJ, Nicholls RJ, Henry MM, Swash M. Electrophysiological and manometric assessment of the pelvic floor in the solitary rectal ulcer syndrome. Br J Surg. 1985;72:131–133. - PubMed

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