Rectal evacuatory dysfunction in patients with genital prolapse

Fomenko O.Yu.

Moscow Regional Research Institute of Obstetrics and Gynecology, Ministry of Health of the Moscow Region, Moscow, Russia

Shelygin Yu.A.

A.N. Ryzhikh State Research Center of Coloproctology, Ministry of Health of Russia;
Department of Coloproctology, Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia

Popov A.A.

Moskovskiĭ oblastnoĭ NII akusherstva i ginekologii

SPIN RSCI: 5452-6728
Scopus AuthorID: 56720739500

Kozlov V.A.

Institute of Demography, National Research Institute «Higher School of Economics», Government of the Russian Federation, Moscow, Russia

Fedorov A.A.

Moskovskiĭ oblastnoĭ NII akusherstva i ginekologii

Belousova S.V.

Efremova E.S.

Moscow Regional Research Institute of Obstetrics and Gynecology, Ministry of Health of the Moscow Region, Moscow, Russia

Rectal evacuatory dysfunction in patients with genital prolapse

Authors:

Fomenko O.Yu., Shelygin Yu.A., Popov A.A., Kozlov V.A., Fedorov A.A., Belousova S.V., Efremova E.S.

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Journal: Russian Bulletin of Obstetrician-Gynecologist. 2018;18(5): 67‑72

DOI: 10.17116/rosakush20181805167

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Fomenko OYu, Shelygin YuA, Popov AA, Kozlov VA, Fedorov AA, Belousova SV, Efremova ES. Rectal evacuatory dysfunction in patients with genital prolapse. Russian Bulletin of Obstetrician-Gynecologist. 2018;18(5):67‑72. (In Russ.)
https://doi.org/10.17116/rosakush20181805167

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Objective — to identify whether functional defecation disorders may be present in patients with genital prolapse. Subject and methods. Forty patients with symptoms of pelvic floor muscle failure were examined. Their mean age was 56.6±9.5 years. One, two, three or more births were observed in 13 (32.5%), 24 (60%), and 3 (7.5%) patients, respectively. All the patients complained of difficult rectal evacuation, who met the 2016 Rome IV criteria for functional constipation. Group 1 comprised 29 (72.5%) women who had not been operated on; among whom there were 17 patients with complete metrocolpocele and 12 with vaginal wall prolapse (cystocele and/or rectocele); Group 2 consisted of 11 (27.5%) of patients with previous hysterectomy; among them there were 5 with vaginal vault prolapse and 6 vaginal wall prolapse (cystocele and/or rectocele). Results. High-resolution manometry identified that in Group 1 there were functional defecatory disorders in 20 (68.9%) cases: 12 patients with complete metrocolpocele and 8 with cystocele and/or rectocele. No functional defecatory disorders were recorded in 9 (31.1%) patients: 5 patients with complete metrocolpocele and 4 with cystocele and/or rectocele. Among Group 2 patients, these disorders were detected in 8 patients: 4 with complete metrocolpocele and 4 with cystocele and/or rectocele. There were no functional defecatory disorders in 3 cases: 1 patient with complete metrocolpocele and 2 patients with cystocele and/or rectocele. Conclusion. Rectal evacuatory dysfunction in patients with genital prolapse is due not only to organic causes as pelvic prolapse or descent, but also to the presence of instrumentally confirmed functional defecatory disorders in 70% of cases. There are minimal differences in the rate of functional defecatory disorders in patients with genital prolapse in the presence of the uterus and in those after hysterectomy (Pearson’s test, p=0.817; Fisher’s bilateral exact test, p=0.57). There were no significant differences in the number of cases of functional defecatory disorders in patients with complete metrocolpocele and vaginal wall prolapse (cystocele and/or rectocele); Pearson’s χ2; p=0.677; Fisher’s bilateral exact test, p=0,471.

Keywords:

genital prolapse

pelvic floor muscle failure

obstructive defecation

functional defecatory disorders

high-resolution anorectal manometry

evacuation test

Authors:

Fomenko O.Yu.

Moscow Regional Research Institute of Obstetrics and Gynecology, Ministry of Health of the Moscow Region, Moscow, Russia

Shelygin Yu.A.

Popov A.A.

Moskovskiĭ oblastnoĭ NII akusherstva i ginekologii

SPIN RSCI: 5452-6728
Scopus AuthorID: 56720739500

Kozlov V.A.

Institute of Demography, National Research Institute «Higher School of Economics», Government of the Russian Federation, Moscow, Russia

Fedorov A.A.

Moskovskiĭ oblastnoĭ NII akusherstva i ginekologii

Belousova S.V.

Efremova E.S.

Moscow Regional Research Institute of Obstetrics and Gynecology, Ministry of Health of the Moscow Region, Moscow, Russia

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