Skip to main content
Erschienen in: International Urogynecology Journal 5/2012

01.05.2012 | Review Article

Posterior vaginal compartment prolapse and defecatory dysfunction: are they related?

verfasst von: Cara L. Grimes, Emily S. Lukacz

Erschienen in: International Urogynecology Journal | Ausgabe 5/2012

Einloggen, um Zugang zu erhalten

Abstract

While posterior vaginal compartment prolapse and defecatory dysfunction are highly prevalent conditions in women with pelvic floor disorders, the relationship between anatomy and symptoms, specifically obstructed defecation, is incompletely understood. This review discusses the anatomy of the posterior vaginal compartment and definitions of defecatory dysfunction and obstructed defecation. A clinically useful classification system for defecatory dysfunction is highlighted. Available tools for the measurement of symptoms, physical findings, and imaging in women with posterior compartment prolapse are discussed. Based on a critical review of the literature, we investigate and summarize whether posterior compartment anatomy correlates with function. Definitions of obstructed defecation and significant posterior compartment prolapse are proposed for future exploration.
Literatur
1.
Zurück zum Zitat Handa VL, Cundiff G, Chang HH, Helzlsouer KJ (2008) Female sexual function and pelvic floor disorders. Obstet Gynecol 111:1045–1052PubMedCrossRef Handa VL, Cundiff G, Chang HH, Helzlsouer KJ (2008) Female sexual function and pelvic floor disorders. Obstet Gynecol 111:1045–1052PubMedCrossRef
2.
Zurück zum Zitat Ellerkmann RM, Cundiff GW, Melick CF, Nihira MA, Leffler K, Bent AE (2001) Correlation of symptoms with location and severity of pelvic organ prolapse. Am J Obstet Gynecol 185:1332–1337, discussion 1337-8PubMedCrossRef Ellerkmann RM, Cundiff GW, Melick CF, Nihira MA, Leffler K, Bent AE (2001) Correlation of symptoms with location and severity of pelvic organ prolapse. Am J Obstet Gynecol 185:1332–1337, discussion 1337-8PubMedCrossRef
3.
Zurück zum Zitat Hendrix SL, Clark A, Nygaard I, Aragaki A, Barnabei V, McTiernan A (2002) Pelvic organ prolapse in the Women's Health Initiative: gravity and gravidity. Am J Obstet Gynecol 186:1160–1166PubMedCrossRef Hendrix SL, Clark A, Nygaard I, Aragaki A, Barnabei V, McTiernan A (2002) Pelvic organ prolapse in the Women's Health Initiative: gravity and gravidity. Am J Obstet Gynecol 186:1160–1166PubMedCrossRef
4.
Zurück zum Zitat Shorvon PJ, McHugh S, Diamant NE, Somers S, Stevenson GW (1989) Defecography in normal volunteers: results and implications. Gut 30:1737–1749PubMedCrossRef Shorvon PJ, McHugh S, Diamant NE, Somers S, Stevenson GW (1989) Defecography in normal volunteers: results and implications. Gut 30:1737–1749PubMedCrossRef
5.
Zurück zum Zitat Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL (1997) Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 89:501–506PubMedCrossRef Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL (1997) Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 89:501–506PubMedCrossRef
6.
Zurück zum Zitat Erekson EA, Kassis NC, Washington BB, Myers DL (2010) The association between stage II or greater posterior prolapse and bothersome obstructive bowel symptoms. Female Pelvic Med Reconstr Surg 16:59–64PubMedCrossRef Erekson EA, Kassis NC, Washington BB, Myers DL (2010) The association between stage II or greater posterior prolapse and bothersome obstructive bowel symptoms. Female Pelvic Med Reconstr Surg 16:59–64PubMedCrossRef
7.
Zurück zum Zitat Brandt LJ, Prather CM, Quigley EM, Schiller LR, Schoenfeld P, Talley NJ (2005) Systematic review on the management of chronic constipation in North America. Am J Gastroenterol 100(Suppl 1):S5–S21PubMedCrossRef Brandt LJ, Prather CM, Quigley EM, Schiller LR, Schoenfeld P, Talley NJ (2005) Systematic review on the management of chronic constipation in North America. Am J Gastroenterol 100(Suppl 1):S5–S21PubMedCrossRef
8.
Zurück zum Zitat Varma MG, Hart SL, Brown JS, Creasman JM, Van Den Eeden SK, Thom DH (2008) Obstructive defecation in middle-aged women. Dig Dis Sci 53:2702–2709PubMedCrossRef Varma MG, Hart SL, Brown JS, Creasman JM, Van Den Eeden SK, Thom DH (2008) Obstructive defecation in middle-aged women. Dig Dis Sci 53:2702–2709PubMedCrossRef
9.
Zurück zum Zitat Whitcomb EL, Lukacz ES, Lawrence JM, Nager CW, Luber KM (2009) Prevalence of defecatory dysfunction in women with and without pelvic floor disorders. Female Pelvic Med Reconstr Surg 15:179–187. doi:10.1097/SPV.0b013e3181b12e01 Whitcomb EL, Lukacz ES, Lawrence JM, Nager CW, Luber KM (2009) Prevalence of defecatory dysfunction in women with and without pelvic floor disorders. Female Pelvic Med Reconstr Surg 15:179–187. doi:10.​1097/​SPV.​0b013e3181b12e01​
10.
Zurück zum Zitat Stewart WF, Liberman JN, Sandler RS et al (1999) Epidemiology of constipation (EPOC) study in the United States: relation of clinical subtypes to sociodemographic features. Am J Gastroenterol 94:3530–3540PubMedCrossRef Stewart WF, Liberman JN, Sandler RS et al (1999) Epidemiology of constipation (EPOC) study in the United States: relation of clinical subtypes to sociodemographic features. Am J Gastroenterol 94:3530–3540PubMedCrossRef
11.
Zurück zum Zitat Bradley CS, Brown MB, Cundiff GW et al (2006) Bowel symptoms in women planning surgery for pelvic organ prolapse. Am J Obstet Gynecol 195:1814–1819PubMedCrossRef Bradley CS, Brown MB, Cundiff GW et al (2006) Bowel symptoms in women planning surgery for pelvic organ prolapse. Am J Obstet Gynecol 195:1814–1819PubMedCrossRef
12.
Zurück zum Zitat Bradley CS, Nygaard IE (2005) Vaginal wall descensus and pelvic floor symptoms in older women. Obstet Gynecol 106:759–766PubMedCrossRef Bradley CS, Nygaard IE (2005) Vaginal wall descensus and pelvic floor symptoms in older women. Obstet Gynecol 106:759–766PubMedCrossRef
13.
Zurück zum Zitat Tan JS, Lukacz ES, Menefee SA, Powell CR, Nager CW (2005) Predictive value of prolapse symptoms: a large database study. Int Urogynecol J Pelvic Floor Dysfunct 16:203–209, discussion 209PubMedCrossRef Tan JS, Lukacz ES, Menefee SA, Powell CR, Nager CW (2005) Predictive value of prolapse symptoms: a large database study. Int Urogynecol J Pelvic Floor Dysfunct 16:203–209, discussion 209PubMedCrossRef
15.
Zurück zum Zitat Swift SE, Tate SB, Nicholas J (2003) Correlation of symptoms with degree of pelvic organ support in a general population of women: what is pelvic organ prolapse? Am J Obstet Gynecol 189:372–377, discussion 377-9PubMedCrossRef Swift SE, Tate SB, Nicholas J (2003) Correlation of symptoms with degree of pelvic organ support in a general population of women: what is pelvic organ prolapse? Am J Obstet Gynecol 189:372–377, discussion 377-9PubMedCrossRef
16.
Zurück zum Zitat Barber MD, Brubaker L, Nygaard I et al (2009) Defining success after surgery for pelvic organ prolapse. Obstet Gynecol 114:600–609PubMedCrossRef Barber MD, Brubaker L, Nygaard I et al (2009) Defining success after surgery for pelvic organ prolapse. Obstet Gynecol 114:600–609PubMedCrossRef
17.
Zurück zum Zitat Abramov Y, Gandhi S, Goldberg RP, Botros SM, Kwon C, Sand PK (2005) Site-specific rectocele repair compared with standard posterior colporrhaphy. Obstet Gynecol 105:314–318PubMedCrossRef Abramov Y, Gandhi S, Goldberg RP, Botros SM, Kwon C, Sand PK (2005) Site-specific rectocele repair compared with standard posterior colporrhaphy. Obstet Gynecol 105:314–318PubMedCrossRef
18.
Zurück zum Zitat Cundiff GW, Fenner D (2004) Evaluation and treatment of women with rectocele: focus on associated defecatory and sexual dysfunction. Obstet Gynecol 104:1403–1421PubMedCrossRef Cundiff GW, Fenner D (2004) Evaluation and treatment of women with rectocele: focus on associated defecatory and sexual dysfunction. Obstet Gynecol 104:1403–1421PubMedCrossRef
19.
Zurück zum Zitat Kleeman SD, Westermann C, Karram MM (2005) Rectoceles and the anatomy of the posterior vaginal wall: revisited. Am J Obstet Gynecol 193:2050–2055PubMedCrossRef Kleeman SD, Westermann C, Karram MM (2005) Rectoceles and the anatomy of the posterior vaginal wall: revisited. Am J Obstet Gynecol 193:2050–2055PubMedCrossRef
20.
Zurück zum Zitat Kleeman SD, Karram M (2008) Posterior pelvic floor prolapse and a review of the anatomy, preoperative testing and surgical management. Minerva Ginecol 60:165–182PubMed Kleeman SD, Karram M (2008) Posterior pelvic floor prolapse and a review of the anatomy, preoperative testing and surgical management. Minerva Ginecol 60:165–182PubMed
21.
Zurück zum Zitat Leffler KS, Thompson JR, Cundiff GW et al (2001) Attachment of the rectovaginal septum to the pelvic sidewall. Am J Obstet Gynecol 185:41–43PubMedCrossRef Leffler KS, Thompson JR, Cundiff GW et al (2001) Attachment of the rectovaginal septum to the pelvic sidewall. Am J Obstet Gynecol 185:41–43PubMedCrossRef
22.
Zurück zum Zitat DeLancey JO (1999) Structural anatomy of the posterior pelvic compartment as it relates to rectocele. Am J Obstet Gynecol 180:815–823PubMedCrossRef DeLancey JO (1999) Structural anatomy of the posterior pelvic compartment as it relates to rectocele. Am J Obstet Gynecol 180:815–823PubMedCrossRef
23.
Zurück zum Zitat Abendstein B, Petros PE, Richardson PA, Goeschen K, Dodero D (2008) The surgical anatomy of rectocele and anterior rectal wall intussusception. Int Urogynecol J Pelvic Floor Dysfunct 19:705–710PubMedCrossRef Abendstein B, Petros PE, Richardson PA, Goeschen K, Dodero D (2008) The surgical anatomy of rectocele and anterior rectal wall intussusception. Int Urogynecol J Pelvic Floor Dysfunct 19:705–710PubMedCrossRef
24.
Zurück zum Zitat Richardson AC (1996) Female pelvic floor support defects. Int Urogynecol J Pelvic Floor Dysfunct 7:241PubMedCrossRef Richardson AC (1996) Female pelvic floor support defects. Int Urogynecol J Pelvic Floor Dysfunct 7:241PubMedCrossRef
25.
Zurück zum Zitat Nichols DH (1996) Vaginal surgery. Lippincott Williams & Wilkins, Philadelphia Nichols DH (1996) Vaginal surgery. Lippincott Williams & Wilkins, Philadelphia
26.
Zurück zum Zitat Richardson AC (1993) The rectovaginal septum revisited: its relationship to rectocele and its importance in rectocele repair. Clin Obstet Gynecol 36:976–983PubMedCrossRef Richardson AC (1993) The rectovaginal septum revisited: its relationship to rectocele and its importance in rectocele repair. Clin Obstet Gynecol 36:976–983PubMedCrossRef
27.
Zurück zum Zitat Bump RC, Mattiasson A, Bo K et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17PubMedCrossRef Bump RC, Mattiasson A, Bo K et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17PubMedCrossRef
28.
Zurück zum Zitat Mellgren A (1995) Diagnosis and treatment of constipation. Eur J Surg 161:623–634PubMed Mellgren A (1995) Diagnosis and treatment of constipation. Eur J Surg 161:623–634PubMed
29.
Zurück zum Zitat Ternent CA, Bastawrous AL, Morin NA, Ellis CN, Hyman NH, Buie WD (2007) Practice parameters for the evaluation and management of constipation. Dis Colon Rectum 50:2013–2022PubMedCrossRef Ternent CA, Bastawrous AL, Morin NA, Ellis CN, Hyman NH, Buie WD (2007) Practice parameters for the evaluation and management of constipation. Dis Colon Rectum 50:2013–2022PubMedCrossRef
30.
Zurück zum Zitat Bharucha AE, Wald A, Enck P, Rao S (2006) Functional anorectal disorders. Gastroenterology 130:1510–1518PubMedCrossRef Bharucha AE, Wald A, Enck P, Rao S (2006) Functional anorectal disorders. Gastroenterology 130:1510–1518PubMedCrossRef
31.
Zurück zum Zitat Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC (2006) Functional bowel disorders. Gastroenterology 130:1480–1491PubMedCrossRef Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC (2006) Functional bowel disorders. Gastroenterology 130:1480–1491PubMedCrossRef
32.
Zurück zum Zitat Haylen BT, de Ridder D, Freeman RM et al (2010) An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn 29:4–20PubMed Haylen BT, de Ridder D, Freeman RM et al (2010) An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn 29:4–20PubMed
33.
Zurück zum Zitat Davis K, Kumar D (2005) Posterior pelvic floor compartment disorders. Best Pract Res Clin Obstet Gynaecol 19:941–958PubMedCrossRef Davis K, Kumar D (2005) Posterior pelvic floor compartment disorders. Best Pract Res Clin Obstet Gynaecol 19:941–958PubMedCrossRef
34.
Zurück zum Zitat American College of Gastroenterology Chronic Constipation Task Force (2005) An evidence-based approach to the management of chronic constipation in North America. Am J Gastroenterol 100(Suppl 1):S1–S4CrossRef American College of Gastroenterology Chronic Constipation Task Force (2005) An evidence-based approach to the management of chronic constipation in North America. Am J Gastroenterol 100(Suppl 1):S1–S4CrossRef
35.
Zurück zum Zitat Gutman RE, Cundiff GW (2007) Chapter 25: anorectal dysfunction. In: Berek J (ed) Novak's gynecology, 14th edn. Lippincott Williams & Wilkins, Philadelphia Gutman RE, Cundiff GW (2007) Chapter 25: anorectal dysfunction. In: Berek J (ed) Novak's gynecology, 14th edn. Lippincott Williams & Wilkins, Philadelphia
36.
Zurück zum Zitat Lewis SJ, Heaton KW (1997) Stool form scale as a useful guide to intestinal transit time. Scand J Gastroenterol 32:920–924PubMedCrossRef Lewis SJ, Heaton KW (1997) Stool form scale as a useful guide to intestinal transit time. Scand J Gastroenterol 32:920–924PubMedCrossRef
37.
Zurück zum Zitat Saad RJ, Rao SS, Koch KL et al (2010) Do stool form and frequency correlate with whole-gut and colonic transit? Results from a multicenter study in constipated individuals and healthy controls. Am J Gastroenterol 105:403–411PubMedCrossRef Saad RJ, Rao SS, Koch KL et al (2010) Do stool form and frequency correlate with whole-gut and colonic transit? Results from a multicenter study in constipated individuals and healthy controls. Am J Gastroenterol 105:403–411PubMedCrossRef
39.
Zurück zum Zitat Barber MD, Kuchibhatla MN, Pieper CF, Bump RC (2001) Psychometric evaluation of 2 comprehensive condition-specific quality of life instruments for women with pelvic floor disorders. Am J Obstet Gynecol 185:1388–1395PubMedCrossRef Barber MD, Kuchibhatla MN, Pieper CF, Bump RC (2001) Psychometric evaluation of 2 comprehensive condition-specific quality of life instruments for women with pelvic floor disorders. Am J Obstet Gynecol 185:1388–1395PubMedCrossRef
40.
Zurück zum Zitat Barber MD, Walters MD, Bump RC (2005) Short forms of two condition-specific quality-of-life questionnaires for women with pelvic floor disorders (PFDI-20 and PFIQ-7). Am J Obstet Gynecol 193:103–113PubMedCrossRef Barber MD, Walters MD, Bump RC (2005) Short forms of two condition-specific quality-of-life questionnaires for women with pelvic floor disorders (PFDI-20 and PFIQ-7). Am J Obstet Gynecol 193:103–113PubMedCrossRef
41.
Zurück zum Zitat Jelovsek JE, Markland AD, Brubaker L et al (2010) Minimum important differences for scales assessing symptom severity and quality of life in patients with fecal incontinence (abstract). Female Pelvic Med Reconstr Surg 16:S66 Jelovsek JE, Markland AD, Brubaker L et al (2010) Minimum important differences for scales assessing symptom severity and quality of life in patients with fecal incontinence (abstract). Female Pelvic Med Reconstr Surg 16:S66
42.
Zurück zum Zitat Grimes CL, Lieschen H, Gutman RE, Shippey S, Cundiff GW, Handa VL (2010) Long-term impact of abdominal sacral colpoperineopexy on symptoms of obstructed defecation. Female Pelvic Med Reconstr Surg 16:234–237PubMedCrossRef Grimes CL, Lieschen H, Gutman RE, Shippey S, Cundiff GW, Handa VL (2010) Long-term impact of abdominal sacral colpoperineopexy on symptoms of obstructed defecation. Female Pelvic Med Reconstr Surg 16:234–237PubMedCrossRef
43.
Zurück zum Zitat Burrows LJ, Sewell C, Leffler KS, Cundiff GW (2003) The accuracy of clinical evaluation of posterior vaginal wall defects. Int Urogynecol J Pelvic Floor Dysfunct 14:160–163, discussion 163PubMedCrossRef Burrows LJ, Sewell C, Leffler KS, Cundiff GW (2003) The accuracy of clinical evaluation of posterior vaginal wall defects. Int Urogynecol J Pelvic Floor Dysfunct 14:160–163, discussion 163PubMedCrossRef
44.
Zurück zum Zitat Hall AF, Theofrastous JP, Cundiff GW et al (1996) Interobserver and intraobserver reliability of the proposed International Continence Society, Society of Gynecologic Surgeons, and American Urogynecologic Society pelvic organ prolapse classification system. Am J Obstet Gynecol 175:1467–1470, discussion 1470-1PubMedCrossRef Hall AF, Theofrastous JP, Cundiff GW et al (1996) Interobserver and intraobserver reliability of the proposed International Continence Society, Society of Gynecologic Surgeons, and American Urogynecologic Society pelvic organ prolapse classification system. Am J Obstet Gynecol 175:1467–1470, discussion 1470-1PubMedCrossRef
45.
Zurück zum Zitat Shull BL (1993) Clinical evaluation of women with pelvic support defects. Clin Obstet Gynecol 36:939–951PubMedCrossRef Shull BL (1993) Clinical evaluation of women with pelvic support defects. Clin Obstet Gynecol 36:939–951PubMedCrossRef
46.
Zurück zum Zitat Baessler K, Schuessler B (2006) Anatomy of the sigmoid colon, rectum, and the rectovaginal pouch in women with enterocele and anterior rectal wall procidentia. Clin Anat 19:125–129PubMedCrossRef Baessler K, Schuessler B (2006) Anatomy of the sigmoid colon, rectum, and the rectovaginal pouch in women with enterocele and anterior rectal wall procidentia. Clin Anat 19:125–129PubMedCrossRef
48.
Zurück zum Zitat Groenendijk AG, Birnie E, de Blok S et al (2009) Clinical-decision taking in primary pelvic organ prolapse; the effects of diagnostic tests on treatment selection in comparison with a consensus meeting. Int Urogynecol J Pelvic Floor Dysfunct 20:711–719PubMedCrossRef Groenendijk AG, Birnie E, de Blok S et al (2009) Clinical-decision taking in primary pelvic organ prolapse; the effects of diagnostic tests on treatment selection in comparison with a consensus meeting. Int Urogynecol J Pelvic Floor Dysfunct 20:711–719PubMedCrossRef
49.
Zurück zum Zitat Groenendijk AG, van der Hulst VP, Birnie E, Bonsel GJ (2008) Correlation between posterior vaginal wall defects assessed by clinical examination and by defecography. Int Urogynecol J Pelvic Floor Dysfunct 19:1291–1297PubMedCrossRef Groenendijk AG, van der Hulst VP, Birnie E, Bonsel GJ (2008) Correlation between posterior vaginal wall defects assessed by clinical examination and by defecography. Int Urogynecol J Pelvic Floor Dysfunct 19:1291–1297PubMedCrossRef
50.
Zurück zum Zitat Altman D, Lopez A, Kierkegaard J et al (2005) Assessment of posterior vaginal wall prolapse: comparison of physical findings to cystodefecoperitoneography. Int Urogynecol J Pelvic Floor Dysfunct 16:96–103, discussion 103PubMedCrossRef Altman D, Lopez A, Kierkegaard J et al (2005) Assessment of posterior vaginal wall prolapse: comparison of physical findings to cystodefecoperitoneography. Int Urogynecol J Pelvic Floor Dysfunct 16:96–103, discussion 103PubMedCrossRef
51.
Zurück zum Zitat Kenton K, Shott S, Brubaker L (1999) The anatomic and functional variability of rectoceles in women. Int Urogynecol J Pelvic Floor Dysfunct 10:96–99PubMedCrossRef Kenton K, Shott S, Brubaker L (1999) The anatomic and functional variability of rectoceles in women. Int Urogynecol J Pelvic Floor Dysfunct 10:96–99PubMedCrossRef
52.
Zurück zum Zitat Broekhuis SR, Futterer JJ, Barentsz JO, Vierhout ME, Kluivers KB (2009) A systematic review of clinical studies on dynamic magnetic resonance imaging of pelvic organ prolapse: the use of reference lines and anatomical landmarks. Int Urogynecol J Pelvic Floor Dysfunct 20:721–729PubMedCrossRef Broekhuis SR, Futterer JJ, Barentsz JO, Vierhout ME, Kluivers KB (2009) A systematic review of clinical studies on dynamic magnetic resonance imaging of pelvic organ prolapse: the use of reference lines and anatomical landmarks. Int Urogynecol J Pelvic Floor Dysfunct 20:721–729PubMedCrossRef
53.
Zurück zum Zitat Broekhuis SR, Kluivers KB, Hendriks JC, Futterer JJ, Barentsz JO, Vierhout ME (2009) POP-Q, dynamic MR imaging, and perineal ultrasonography: do they agree in the quantification of female pelvic organ prolapse? Int Urogynecol J Pelvic Floor Dysfunct. doi:10.1007/s00192-009-0821-1 Broekhuis SR, Kluivers KB, Hendriks JC, Futterer JJ, Barentsz JO, Vierhout ME (2009) POP-Q, dynamic MR imaging, and perineal ultrasonography: do they agree in the quantification of female pelvic organ prolapse? Int Urogynecol J Pelvic Floor Dysfunct. doi:10.​1007/​s00192-009-0821-1
54.
Zurück zum Zitat Weber AM, Walters MD, Ballard LA, Booher DL, Piedmonte MR (1998) Posterior vaginal prolapse and bowel function. Am J Obstet Gynecol 179:1446–1449, discussion 1449-50PubMedCrossRef Weber AM, Walters MD, Ballard LA, Booher DL, Piedmonte MR (1998) Posterior vaginal prolapse and bowel function. Am J Obstet Gynecol 179:1446–1449, discussion 1449-50PubMedCrossRef
55.
Zurück zum Zitat Jelovsek JE, Barber MD, Paraiso MF, Walters MD (2005) Functional bowel and anorectal disorders in patients with pelvic organ prolapse and incontinence. Am J Obstet Gynecol 193:2105–2111PubMedCrossRef Jelovsek JE, Barber MD, Paraiso MF, Walters MD (2005) Functional bowel and anorectal disorders in patients with pelvic organ prolapse and incontinence. Am J Obstet Gynecol 193:2105–2111PubMedCrossRef
56.
Zurück zum Zitat da Silva GM, Gurland B, Sleemi A, Levy G (2006) Posterior vaginal wall prolapse does not correlate with fecal symptoms or objective measures of anorectal function. Am J Obstet Gynecol 195:1742–1747PubMedCrossRef da Silva GM, Gurland B, Sleemi A, Levy G (2006) Posterior vaginal wall prolapse does not correlate with fecal symptoms or objective measures of anorectal function. Am J Obstet Gynecol 195:1742–1747PubMedCrossRef
57.
Zurück zum Zitat Barber MD, Walters M, Bump R (2003) Association of magnitude of pelvic organ prolapse and presentation and severity of symptoms (abstract). J Pelvic Med Surg 208 Barber MD, Walters M, Bump R (2003) Association of magnitude of pelvic organ prolapse and presentation and severity of symptoms (abstract). J Pelvic Med Surg 208
58.
Zurück zum Zitat Fialkow MF, Gardella C, Melville J, Lentz GM, Fenner DE (2002) Posterior vaginal wall defects and their relation to measures of pelvic floor neuromuscular function and posterior compartment symptoms. Am J Obstet Gynecol 187:1443–1448, discussion 1448-9PubMedCrossRef Fialkow MF, Gardella C, Melville J, Lentz GM, Fenner DE (2002) Posterior vaginal wall defects and their relation to measures of pelvic floor neuromuscular function and posterior compartment symptoms. Am J Obstet Gynecol 187:1443–1448, discussion 1448-9PubMedCrossRef
59.
Zurück zum Zitat Dietz HP, Korda A (2005) Which bowel symptoms are most strongly associated with a true rectocele? Aust N Z J Obstet Gynaecol 45:505–508PubMedCrossRef Dietz HP, Korda A (2005) Which bowel symptoms are most strongly associated with a true rectocele? Aust N Z J Obstet Gynaecol 45:505–508PubMedCrossRef
60.
Zurück zum Zitat Burrows LJ, Meyn LA, Walters MD, Weber AM (2004) Pelvic symptoms in women with pelvic organ prolapse. Obstet Gynecol 104:982–988PubMedCrossRef Burrows LJ, Meyn LA, Walters MD, Weber AM (2004) Pelvic symptoms in women with pelvic organ prolapse. Obstet Gynecol 104:982–988PubMedCrossRef
61.
Zurück zum Zitat Kahn MA, Breitkopf CR, Valley MT et al (2005) Pelvic Organ Support Study (POSST) and bowel symptoms: straining at stool is associated with perineal and anterior vaginal descent in a general gynecologic population. Am J Obstet Gynecol 192:1516–1522PubMedCrossRef Kahn MA, Breitkopf CR, Valley MT et al (2005) Pelvic Organ Support Study (POSST) and bowel symptoms: straining at stool is associated with perineal and anterior vaginal descent in a general gynecologic population. Am J Obstet Gynecol 192:1516–1522PubMedCrossRef
62.
Zurück zum Zitat Slieker-ten Hove MC, Pool-Goudzwaard AL, Eijkemans MJ et al (2009) The prevalence of pelvic organ prolapse symptoms and signs and their relation with bladder and bowel disorders in a general female population. Int Urogynecol J Pelvic Floor Dysfunct 20:1037–1045PubMedCrossRef Slieker-ten Hove MC, Pool-Goudzwaard AL, Eijkemans MJ et al (2009) The prevalence of pelvic organ prolapse symptoms and signs and their relation with bladder and bowel disorders in a general female population. Int Urogynecol J Pelvic Floor Dysfunct 20:1037–1045PubMedCrossRef
63.
Zurück zum Zitat Morgan DM, DeLancey JO, Guire KE, Fenner DE (2007) Symptoms of anal incontinence and difficult defecation among women with prolapse and a matched control cohort. Am J Obstet Gynecol 197(509):e1–e6. doi:10.1016/j.ajog.2007.03.074 PubMed Morgan DM, DeLancey JO, Guire KE, Fenner DE (2007) Symptoms of anal incontinence and difficult defecation among women with prolapse and a matched control cohort. Am J Obstet Gynecol 197(509):e1–e6. doi:10.​1016/​j.​ajog.​2007.​03.​074 PubMed
64.
Zurück zum Zitat Saks EK, Harvie HS, Asfaw TS, Arya LA (2010) Clinical significance of obstructive defecatory symptoms in women with pelvic organ prolapse. Int J Gynaecol Obstet 111:237–240PubMedCrossRef Saks EK, Harvie HS, Asfaw TS, Arya LA (2010) Clinical significance of obstructive defecatory symptoms in women with pelvic organ prolapse. Int J Gynaecol Obstet 111:237–240PubMedCrossRef
65.
Zurück zum Zitat Digesu GA, Khullar V, Cardozo L, Robinson D, Salvatore S (2005) P-QOL: a validated questionnaire to assess the symptoms and quality of life of women with urogenital prolapse. Int Urogynecol J Pelvic Floor Dysfunct 16:176–181, discussion 181PubMedCrossRef Digesu GA, Khullar V, Cardozo L, Robinson D, Salvatore S (2005) P-QOL: a validated questionnaire to assess the symptoms and quality of life of women with urogenital prolapse. Int Urogynecol J Pelvic Floor Dysfunct 16:176–181, discussion 181PubMedCrossRef
66.
Zurück zum Zitat Pescatori M, Spyrou M, Pulvirenti d'Urso A (2006) A prospective evaluation of occult disorders in obstructed defecation using the 'iceberg diagram'. Colorectal Dis 8:785–789PubMedCrossRef Pescatori M, Spyrou M, Pulvirenti d'Urso A (2006) A prospective evaluation of occult disorders in obstructed defecation using the 'iceberg diagram'. Colorectal Dis 8:785–789PubMedCrossRef
67.
Zurück zum Zitat Gustilo-Ashby AM, Paraiso MF, Jelovsek JE, Walters MD, Barber MD (2007) Bowel symptoms 1 year after surgery for prolapse: further analysis of a randomized trial of rectocele repair. Am J Obstet Gynecol 197:76.e1–76.e5. doi:10.1016/j.ajog.2007.02.045 CrossRef Gustilo-Ashby AM, Paraiso MF, Jelovsek JE, Walters MD, Barber MD (2007) Bowel symptoms 1 year after surgery for prolapse: further analysis of a randomized trial of rectocele repair. Am J Obstet Gynecol 197:76.e1–76.e5. doi:10.​1016/​j.​ajog.​2007.​02.​045 CrossRef
69.
Zurück zum Zitat Miedel A, Tegerstedt G, Maehle-Schmidt M, Nyren O, Hammarstrom M (2008) Symptoms and pelvic support defects in specific compartments. Obstet Gynecol 112:851–858PubMedCrossRef Miedel A, Tegerstedt G, Maehle-Schmidt M, Nyren O, Hammarstrom M (2008) Symptoms and pelvic support defects in specific compartments. Obstet Gynecol 112:851–858PubMedCrossRef
70.
Zurück zum Zitat Soligo M, Salvatore S, Emmanuel AV, De Ponti E, Zoccatelli M, Cortese M, Milani R (2006) Patterns of constipation in urogynecology: clinical importance and pathophysiologic insights. Am J Obstet Gynecol 195:50–55PubMedCrossRef Soligo M, Salvatore S, Emmanuel AV, De Ponti E, Zoccatelli M, Cortese M, Milani R (2006) Patterns of constipation in urogynecology: clinical importance and pathophysiologic insights. Am J Obstet Gynecol 195:50–55PubMedCrossRef
71.
Zurück zum Zitat Bradley CS, Zimmerman MB, Wang Q, Nygaard IE, Women's Health I (2008) Vaginal descent and pelvic floor symptoms in postmenopausal women: a longitudinal study. Obstet Gynecol 111:1148–1153PubMedCrossRef Bradley CS, Zimmerman MB, Wang Q, Nygaard IE, Women's Health I (2008) Vaginal descent and pelvic floor symptoms in postmenopausal women: a longitudinal study. Obstet Gynecol 111:1148–1153PubMedCrossRef
Metadaten
Titel
Posterior vaginal compartment prolapse and defecatory dysfunction: are they related?
verfasst von
Cara L. Grimes
Emily S. Lukacz
Publikationsdatum
01.05.2012
Verlag
Springer-Verlag
Erschienen in
International Urogynecology Journal / Ausgabe 5/2012
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-011-1629-3

Weitere Artikel der Ausgabe 5/2012

International Urogynecology Journal 5/2012 Zur Ausgabe

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Erhöhte Mortalität bei postpartalem Brustkrebs

07.05.2024 Mammakarzinom Nachrichten

Auch für Trägerinnen von BRCA-Varianten gilt: Erkranken sie fünf bis zehn Jahre nach der letzten Schwangerschaft an Brustkrebs, ist das Sterberisiko besonders hoch.

Menopausale Hormontherapie für Frauen über 65?

07.05.2024 Klimakterium und Menopause Nachrichten

In den USA erhalten nicht wenige Frauen auch noch im Alter über 65 eine menopausale Hormontherapie. Welche positiven und negativen gesundheitlichen Konsequenzen daraus möglicherweise resultieren, wurde anhand von Versicherungsdaten analysiert.

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Klinik aktuell Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.