Department of Obstetrics and Gynecology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Obstetrics and Gynecology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
BC in Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
Introduction: Defecatory dysfunction is a common problem among women who referred for urogynecological care. Pelvic organ prolapse (POP) which is a downward displacement of pelvic organs is one of the common condition among patients with defecatory problems . This study was planned to evaluate the correlation of obstructive defecatory symptoms with the site and severity of pelvic organ prolapse and the anorectal manometry results.
Methods: This cross-sectional study was performed between Dec 2018 and Nov 2019. About 150 women with symptoms of defecatory problems were enrolled. Patients were classified in two groups according to each compartment prolapse staging and severity; stage ≤2 and stage >2. The correlation between defecatory symptoms and pelvic organ prolapse examination, anorectal examination and anal manometry were evaluated.
Results: A total of 150women were evaluated. There was a significant correlation between higher stage of anterior compartment prolapse (cystocele stage>2) and constipation (P=0.035). Although all the defecatory symptoms were more frequent in anterior prolapse stage>2, but the difference was not significant (P>0.05).There was no significant correlation between defecatory symptoms and severity of posterior compartment prolapse. There was a significant correlation between stage>2 of apical prolapse and all the defecatory symptoms (P≤0.05). The abnormal anal resting and squeeze pressure and also abnormal balloon expulsion test were more frequent in stage >2 of all compartment prolapse, but the difference was not significant (P>0.05).
Conclusion:Obstructive defecatory symptoms were more frequent in patients with higher stage of anterior and apical prolapse. Abnormal manometry results were more frequent in patients with defecatory dysfunction with advanced vaginal prolapse.
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