Ultrasound Indicators of Rectal Support Defect in Women With Obstructive Defecatory Symptoms

Rostaminia, Ghazaleh; Javadian, Pouya; Awad, Charbel; Shobeiri, S. Abbas

doi:10.1097/spv.0000000000000511

Cited by 12 publications

(22 citation statements)

References 19 publications

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“…This measurement demonstrates the relative location of the levator plate to the pubic symphysis in the resting position. 13,15 Levator Ani Muscle Deficiency This method scores the grade of defects in levator ani muscle subdivisions. 15,16 The scores range from 0 to 3 for each muscle subdivision (puborectalis and illiococcygeus) based on the thickness of the muscle and the presence of an avulsion from the pelvis.…”

Section: Three-dimensional Pelvic Floor Ultrasound Measurements Taken...mentioning

confidence: 99%

“…9 Pelvic floor dynamic ultrasound has also been established as an important tool in the assessment of rectocele, enterocele, rectal intussusception, and prolapse with good agreement with MR defecography findings. 3,[10][11][12][13] Although both MR defecography and ultrasound can be used to assess pelvic floor disorders, ultrasound is cheaper, faster, and more widely available compared with MR defecography. This makes ultrasound an appealing alternative for evaluation of ODS.…”

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confidence: 99%

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Obstructed Defecation Symptom Severity and Degree of Rectal Hypermobility and Folding Detected by Dynamic Ultrasound

Routzong

Abramowitch

Chang

et al. 2021

Ultrasound Quarterly

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We used dynamic pelvic floor ultrasound to investigate the relationship between obstructed defecation symptom (ODS) severity and the degree of rectal hypermobility/folding. In this retrospective study, women who presented with ODS from October 2017 to January 2019 and underwent an interview, pelvic examination, and pelvic floor ultrasound were recruited. Patients were diagnosed with abdominal constipation, dyssynergia, or pelvic constipation. Pelvic constipation patients were categorized based on their reported frequency of incomplete emptying of stool (<50% or ≥50% of bowel movements) representing mild and severe ODS, respectively. Using dynamic ultrasound, rectal hypermobility was quantified via rectovaginal septum length at rest and Valsalva and its compression ratio, where shorter lengths and larger compression ratios are indicative of increased rectal hypermobility. One hundred twenty-one patients (41 with abdominal constipation, 7 with dyssynergia, and 73 with pelvic constipation) were included. Compression ratios were higher in women with severe versus mild ODS (17.36 ± 16.89 vs 36.38 ± 25.82, P = 0.0039). The risk of having severe symptoms was 4 times greater (odds ratio = 4.2, 95% confidence interval = 1.4 to 12.6, P = 0.01) among those with a high compression ratio (≥20%) after controlling for age, body mass index, and levator plate descent angle. Incomplete emptying was weakly, positively, linearly correlated with rectal hypermobility/folding (r = −0.2724, −0.3767 to 0.3922, and P = 0.0197, 0.0010, 0.0006, respectively). Women with more severe ODS experienced more rectal hypermobility/folding as measured via dynamic ultrasound-a cheaper, effective alternative to magnetic resonance defecography for evaluation of obstructed defecation.

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Section: Three-dimensional Pelvic Floor Ultrasound Measurements Taken...mentioning

confidence: 99%

mentioning

confidence: 99%

Obstructed Defecation Symptom Severity and Degree of Rectal Hypermobility and Folding Detected by Dynamic Ultrasound

Routzong

Abramowitch

Chang

et al. 2021

Ultrasound Quarterly

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“…The 3D volume is useful for visualization of the levator ani muscle subdivisions and defects, vaginal masses and cysts, slings, and mesh (Figure ) . The levator ani muscle integrity, minimal levator hiatus area, anteroposterior diameter, urethral length, and sling and mesh position and dimensions, along with the levator plate descent angle, should be documented Endoanal Ultrasound Perform a 3D EAUS examination. Endoanal ultrasound may be useful for evaluation of an anal sphincter defect or pathology .…”

Section: Specifications Of the Examinationmentioning

confidence: 99%

AIUM/IUGA Practice Parameter for the Performance of Urogynecological Ultrasound Examinations: Developed in Collaboration with the ACR, the AUGS, the AUA, and the SRU

2019

J of Ultrasound Medicine

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he clinical aspects of this parameter were developed by the AIUM/IUGA Collaborative Committee in collaboration with other organizations whose members use ultrasound for performing pelvic floor examinations (see "Acknowledgments"). Recommendations for practitioner requirements, the written request for the examination, procedure documentation, and quality control vary among the organizations and are addressed by each separately.An ultrasound examination is a proven and useful procedure for evaluating the pelvic floor, including the urethra, bladder, vagina, uterus if possible, anorectum, and levator ani muscle. Pelvic floor ultrasound (PFUS) examinations should be performed only when there is a valid medical reason. The lowest possible ultrasonic exposure settings should be used to gain the necessary diagnostic information. Although it is not possible to detect all pelvic floor pathology, adherence to the following practice parameter will maximize the possibility of detecting many conditions.

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“…3). Patients with levator ani muscle disruption lack normal anorectal plate function and present with anorectal dysfunction [11]. We strongly recommend pelvic floor ultrasonography or MRI preoperatively as women with pelvic organ prolapse have an odds ratio of 7.3 for having major levator ani defects as compared to women without prolapse.…”

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The practical value of levator ani muscle injury repair

Alshiek

Shobeiri

2019

Tech Coloproctol

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Ultrasound Indicators of Rectal Support Defect in Women With Obstructive Defecatory Symptoms

Abstract: Women with obstructive defecatory symptoms have wider rectum and descendent levator plate regardless of the stage of prolapse as measured by POPQ or the severity of rectocele.

Cited by 12 publications

References 19 publications

Obstructed Defecation Symptom Severity and Degree of Rectal Hypermobility and Folding Detected by Dynamic Ultrasound

Obstructed Defecation Symptom Severity and Degree of Rectal Hypermobility and Folding Detected by Dynamic Ultrasound

AIUM/IUGA Practice Parameter for the Performance of Urogynecological Ultrasound Examinations: Developed in Collaboration with the ACR, the AUGS, the AUA, and the SRU

The practical value of levator ani muscle injury repair

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