nach oben

coloproctology

Erschienen in:

10.06.2021 | Rektozele | Leitthema

Urogynäkologie meets Koloproktologie

Befunde und Symptome

verfasst von: PD Dr. med. Kaven Baessler, PD Dr. med. Carsten Kempkensteffen

Erschienen in: coloproctology | Ausgabe 4/2021

Einloggen, um Zugang zu erhalten

Zusammenfassung

Zu Beckenbodendysfunktionen gehören auch Stuhlentleerungsstörungen und sexuelle Probleme. Um die Assoziation von anorektalen Symptomen, Rektozele und Sexualfunktion zu untersuchen, erfolgte eine sekundäre Datenanalyse von urogynäkologischen Patientinnen und gesunden Probandinnen, die für den Validierungsprozess des Deutschen Beckenboden-Fragenbogens rekrutiert worden waren: 63 urogynäkologische Patientinnen und 24 gesunde Probandinnen. Eine Rektozele kam bei 50 % der urogynäkologischen Patientinnen vor, aber nur bei einer gesunden Frau. Je größer die Rektozele, desto mehr Stuhlentleerungsstörungen wurden angegeben. Diejenigen, die vermehrt pressen mussten, unterstützten die Defäkation auch häufiger digital. Stuhlentleerungsstörungen waren mit dem Gefühl der weiten Scheide beim Sex assoziiert. Zusammenfassend bestätigt diese Auswertung, dass vermehrtes Pressen mit einer Rektozele, Stuhlentleerungsstörungen und dem Gefühl der zu weiten Scheide assoziiert ist.

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 20:1037–1045PubMedPubMedCentral

Baessler K, O’Neill S, Maher C (2006) Prevalence, incidence, progression and regression of pelvic organ prolapse in a community cohort: Results of a 5-year longitudinal study. Neurourol Urodynam 25:520–522

Weber AM, Walters MD, Ballard LA et al (1998) Posterior vaginal prolapse and bowel function. Am J Obstet Gynecol 179:1446–1449 (discussion 1449–1450)PubMed

Hannestad YS, Rortveit G, Sandvik H et al (2000) A community-based epidemiological survey of female urinary incontinence: the Norwegian EPINCONT study. Epidemiology of Incontinence in the County of Nord-Trondelag. J Clin Epidemiol 53:1150–1157PubMed

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. Int Urogynecol J 21:5–26PubMed

Sultan AH, Monga A, Lee J et al (2017) An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female anorectal dysfunction. Int Urogynecol J 28:5–31PubMed

Bo K, Frawley HC, Haylen BT et al (2017) An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for the conservative and nonpharmacological management of female pelvic floor dysfunction. Int Urogynecol J 28:191–213PubMed

Baessler K, O’Neill SM, Maher CF et al (2010) A validated self-administered female pelvic floor questionnaire. Int Urogynecol J 21:163–172PubMed

Baessler K, Kempkensteffen C (2009) Validation of a comprehensive pelvic floor questionnaire for the hospital, private practice and research. Gynakol Geburtshilfliche Rundsch 49:299–307PubMed

10.

Baessler K, Junginger B (2011) Validation of a pelvic floor questionnaire with improvement and satisfaction scales to assess symptom severity, bothersomeness and quality of life before and after pelvic floor therapy. Aktuelle Urol 42:316–322PubMed

11.

Harewood GC, Coulie B, Camilleri M et al (1999) Descending perineum syndrome: audit of clinical and laboratory features and outcome of pelvic floor retraining. Am J Gastroenterol 94:126–130PubMed

12.

Dietz HP, Alcoba ME, Friedman T et al (2021) Is perineal hypermobility an independent predictor of obstructive defecation? Int Urogynecol J. https://doi.org/10.1007/s00192-021-04734-wCrossRefPubMed

13.

Guzman Rojas R, Kamisan Atan I, Shek KL et al (2016) The prevalence of abnormal posterior compartment anatomy and its association with obstructed defecation symptoms in urogynecological patients. Int Urogynecol J 27:939–944PubMed

14.

Rodrigo N, Shek KL, Dietz HP (2011) Rectal intussusception is associated with abnormal levator ani muscle structure and morphometry. Tech Coloproctol 15:39–43PubMed

15.

Siproudhis L, Ropert A, Lucas J et al (1992) Defecatory disorders, anorectal and pelvic floor dysfunction: a polygamy? Radiologic and manometric studies in 41 patients. Int J Colorectal Dis 7:102–107PubMed

16.

Hai-Ying C, Guzman Rojas R, Hall JC et al (2016) Digitation associated with defecation: what does it mean in urogynaecological patients? Int Urogynecol J 27:229–232PubMed

17.

Rortveit G, Daltveit AK, Hannestad YS et al (2003) Vaginal delivery parameters and urinary incontinence: the Norwegian EPINCONT study. Am J Obstet Gynecol 189:1268–1274PubMed

18.

Dietz HP, Gomez M, Atan IK et al (2018) Association between vaginal parity and rectocele. Int Urogynecol J 29:1479–1483PubMed

19.

Usmani SA, Reckenberg K, Johnson O et al (2019) Relative risk of adverse events and treatment discontinuations between older and non-older adults treated with antimuscarinics for overactive bladder: a systematic review and meta-analysis. Drugs Aging 36:639–645PubMed

20.

Rortveit G, Hunskaar S (2006) Urinary incontinence and age at the first and last delivery: the Norwegian HUNT/EPINCONT study. Am J Obstet Gynecol 195:433–438PubMed

21.

Jelovsek JE, Piccorelli A, Barber MD et al (2013) Prediction models for postpartum urinary and fecal incontinence in primiparous women. Female Pelvic Med Reconstr Surg 19:110–118PubMed

22.

Metz M, Junginger B, Henrich W et al (2017) Development and validation of a questionnaire for the assessment of pelvic floor disorders and their risk factors during pregnancy and post partum. Geburtshilfe Frauenheilkd 77:358–365PubMedPubMedCentral

23.

Hendrix SL, Clark A, Nygaard I et al (2002) Pelvic organ prolapse in the Women’s Health Initiative: gravity and gravidity. Am J Obstet Gynecol 186:1160–1166PubMed

24.

Olsen AL, Smith VJ, Bergstrom JO et al (1997) Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 89:501–506PubMed

25.

Carley ME, Schaffer J (2000) Urinary incontinence and pelvic organ prolapse in women with Marfan or Ehlers Danlos syndrome. Am J Obstet Gynecol 182:1021–1023PubMed

26.

Rinne KM, Kirkinen PP (1999) What predisposes young women to genital prolapse? Eur J Obstet Gynecol Reprod Biol 84:23–25PubMed

27.

Woodman PJ, Swift SE, O’Boyle AL et al (2006) Prevalence of severe pelvic organ prolapse in relation to job description and socioeconomic status: a multicenter cross-sectional study. Int Urogynecol J Pelvic Floor Dysfunct 17:340–345PubMed

28.

Hannestad YS, Lie RT, Rortveit G et al (2004) Familial risk of urinary incontinence in women: population based cross sectional study. BMJ 329:889–891PubMedPubMedCentral

29.

Hannestad YS, Rortveit G, Daltveit AK et al (2003) Are smoking and other lifestyle factors associated with female urinary incontinence? The Norwegian EPINCONT Study. BJOG 110:247–254PubMed

30.

Nygaard I, Barber MD, Burgio KL et al (2008) Prevalence of symptomatic pelvic floor disorders in US women. JAMA 300:1311–1316PubMedPubMedCentral

31.

Rortveit G, Brown JS, Thom DH et al (2007) Symptomatic pelvic organ prolapse: prevalence and risk factors in a population-based, racially diverse cohort. Obstet Gynecol 109:1396–1403PubMed

32.

Weber AM, Walters MD, Piedmonte MR (2000) Sexual function and vaginal anatomy in women before and after surgery for pelvic organ prolapse and urinary incontinence. Am J Obstet Gynecol 182:1610–1615PubMed

33.

Baessler K, Stanton SL (2004) Does Burch colposuspension cure coital incontinence? Am J Obstet Gynecol 190:1030–1033PubMed

34.

Hilton P (1988) Urinary incontinence during sexual intercourse: a common, but rarely volunteered, symptom. Br J Obstet Gynaecol 95:377–381PubMed

35.

Schoenfeld M, Fuermetz A, Muenster M et al (2013) Sexuality in German urogynecological patients and healthy controls: is there a difference with respect to the diagnosis? Eur J Obstet Gynecol Reprod Biol 170:567–570PubMed

36.

Manzini C, Friedman T, Turel F et al (2020) Vaginal laxity: which measure of levator ani distensibility is most predictive? Ultrasound Obstet Gynecol 55:683–687PubMedPubMedCentral

37.

O’Boyle AL, Woodman PJ, O’Boyle JD et al (2002) Pelvic organ support in nulliparous pregnant and nonpregnant women: a case control study. Am J Obstet Gynecol 187:99–102PubMed

38.

Swift S, Woodman P, O’Boyle A et al (2005) Pelvic Organ Support Study (POSST): the distribution, clinical definition, and epidemiologic condition of pelvic organ support defects. Am J Obstet Gynecol 192:795–806PubMed

39.

DeLancey JO (1999) Structural anatomy of the posterior pelvic compartment as it relates to rectocele. Am J Obstet Gynecol 180:815–823PubMed

40.

Dietz HP, Lanzarone V (2005) Levator trauma after vaginal delivery. Obstet Gynecol 106:707–712PubMed

41.

Handa VL, Blomquist JL, Roem J et al (2019) Pelvic floor disorders after obstetric avulsion of the levator ani muscle. Female Pelvic Med Reconstr Surg 25:3–7PubMed

42.

Albrich SB, Welker K, Wolpert B et al (2017) How common is ballooning? Hiatal area on 3D transperineal ultrasound in urogynecological patients and its association with lower urinary tract symptoms. Arch Gynecol Obstet 295:103–109PubMed

43.

van Delft K, Thakar R, Sultan AH et al (2014) Levator ani muscle avulsion during childbirth: a risk prediction model. BJOG 121:1155–1163 (discussion 1163)PubMed

44.

Harvey MA, Pierce M, Alter JE et al (2015) Obstetrical anal sphincter injuries (OASIS): prevention, recognition, and repair. J Obstet Gynaecol Can 37:1131–1148PubMed

45.

Scheer I, Thakar R, Sultan AH (2009) Mode of delivery after previous obstetric anal sphincter injuries (OASIS)—a reappraisal? Int Urogynecol J Pelvic Floor Dysfunct 20:1095–1101PubMed

46.

Andrews V, Thakar R, Sultan AH (2009) Structured hands-on training in repair of obstetric anal sphincter injuries (OASIS): an audit of clinical practice. Int Urogynecol J Pelvic Floor Dysfunct 20:193–199PubMed

47.

Andrews V, Thakar R, Sultan AH (2009) Outcome of obstetric anal sphincter injuries (OASIS)—role of structured management. Int Urogynecol J Pelvic Floor Dysfunct 20:973–978PubMed

48.

Rachaneni S, Gurol-Urganci I, Basu M et al (2021) Short statured primigravidae: options for the obstetric management from a survey of UK obstetricians. Eur J Obstet Gynecol Reprod Biol 256:379–384PubMed

49.

Roper JC, Amber N, Wan OYK et al (2020) Review of available national guidelines for obstetric anal sphincter injury. Int Urogynecol J 31:2247–2259PubMedPubMedCentral

50.

Volloyhaug I, Taithongchai A, Van Gruting I et al (2019) Levator ani muscle morphology and function in women with obstetric anal sphincter injury. Ultrasound Obstet Gynecol 53:410–416PubMed

51.

Murad-Regadas SM, Regadas FS, Barreto RG et al (2010) Is dynamic two-dimensional anal ultrasonography useful in the assessment of anismus? A comparison with manometry. Arq Gastroenterol 47:368–372PubMed

52.

Roth TM (2018) Successful treatment of paradoxical puborectalis contraction and intractable anorectal pain with sacral neuromodulation. Female Pelvic Med Reconstr Surg 24:e21–e22PubMed

53.

Rachaneni S, Atan IK, Shek KL et al (2017) Digital rectal examination in the evaluation of rectovaginal septal defects. Int Urogynecol J 28:1401–1405PubMed

54.

Dietz HP, Korda A (2005) Which bowel symptoms are most strongly associated with a true rectocele? Aust N Z J Obstet Gynaecol 45:505–508PubMed

55.

Maher CF, Baessler KK, Barber MD et al (2018) Summary: 2017 international consultation on incontinence evidence-based surgical pathway for pelvic organ prolapse. Female Pelvic Med Reconstr Surg. https://doi.org/10.1097/SPV.0000000000000591CrossRefPubMed

56.

Baessler K, Aigmuller T, Albrich S et al (2016) Diagnosis and therapy of female pelvic organ prolapse. Guideline of the DGGG, SGGG and OEGGG (S2e-level, AWMF registry number 015/006, April 2016). Geburtshilfe Frauenheilkd 76:1287–1301PubMedPubMedCentral

57.

Yamada T, Matsubara S (2011) Rectocoele, but not cystocoele, may predict unsuccessful pessary fitting. J Obstet Gynaecol 31:441–442PubMed

58.

Mowat A, Maher D, Baessler K et al (2018) Surgery for women with posterior compartment prolapse. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD012975CrossRefPubMedPubMedCentral

59.

DeLancey JO, Morgan DM, Fenner DE et al (2007) Comparison of levator ani muscle defects and function in women with and without pelvic organ prolapse. Obstet Gynecol 109:295–302PubMed

60.

Sheiner E, Levy A, Walfisch A et al (2005) Third degree perineal tears in a university medical center where midline episiotomies are not performed. Arch Gynecol Obstet 271:307–310PubMed

61.

Hudelist G, Gelle’n J, Singer C et al (2005) Factors predicting severe perineal trauma during childbirth: role of forceps delivery routinely combined with mediolateral episiotomy. Am J Obstet Gynecol 192:875–881PubMed

Titel: Urogynäkologie meets Koloproktologie
Befunde und Symptome
verfasst von: PD Dr. med. Kaven Baessler
PD Dr. med. Carsten Kempkensteffen
Publikationsdatum: 10.06.2021
Verlag: Springer Medizin
Schlagwort: Rektozele
Erschienen in: coloproctology / Ausgabe 4/2021
Print ISSN: 0174-2442
Elektronische ISSN: 1615-6730
DOI: https://doi.org/10.1007/s00053-021-00544-2

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

15.04.2024 | Inkretinmimetika | Nachrichten

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Urogynäkologie meets Koloproktologie

Befunde und Symptome

Zusammenfassung

Leitlinien kompakt für die Innere Medizin

Neu im Fachgebiet Innere Medizin

Fast jeder zehnte Magen bei Endoskopie noch nicht entleert

Verbesserung der HDL-Funktion als Lipidtherapie floppt in Mega-Studie

Blutdrucksenkung per Spritze additiv zur Standardtherapie wirksam

Vitiligo: Prävalenz steigt und viele Erkrankte werden spät behandelt

Update Innere Medizin

Springer Medizin

Zusammenfassung

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 4/2021

Totale anale Rekonstruktion mit stimulierter Grazilisplastik

Mitteilungen des BCD und der DGK

Rolle von zytoreduktiver Chirurgie und hyperthermer intraperitonealer Chemotherapie bei Patienten mit kolorektalem Karzinom mit peritonealer Metastasierung

Die totale neoadjuvante Therapie mit Kurzzeitstrahlentherapie bei Patienten mit lokal weit fortgeschrittenem Rektumkarzinom

Proktologische Nebenwirkungen nach Strahlentherapie gynäkologischer Tumoren

Vulvadysplasie und Vulvakarzinom

Leitlinien kompakt für die Innere Medizin

Neu im Fachgebiet Innere Medizin

Fast jeder zehnte Magen bei Endoskopie noch nicht entleert

Verbesserung der HDL-Funktion als Lipidtherapie floppt in Mega-Studie

Blutdrucksenkung per Spritze additiv zur Standardtherapie wirksam

Vitiligo: Prävalenz steigt und viele Erkrankte werden spät behandelt

Update Innere Medizin