OBJECTIVE

To clarify the relationship of pelvic floor dysfunction with proctologic diseases in women of late reproductive age.

MATERIAL AND METHODS

A monocenter prospective study in a small clinical group was conducted. The study included 27 women of late reproductive age, patients of the proctology department hospitalized for minor surgical operations for hemorrhoids (37.0%) or rectal polyps (63%). At admission, in addition to anamnesis and proctological examination, all patients underwent bimanual vaginal examination and ultrasonic diagnostics of the organs of the small pelvic and pelvic floor.

RESULTS

Patients of the proctology department most often had a combination of somatic diseases: body overweight — 70.0%, arterial hypertension — 27.8% and type 2 diabetes mellitus — 11.1% and gynecological diseases 22.2%, a high percentage of previously undetected pelvic floor dysfunction, the diagnosis of which during bimanual examination amounted to 51.9% and was confirmed by ultrasound, and the degree and forms of changes were specified: presence of rectocele in 63.0%, hypermobility of urethrovesical segment in 40.0%, combination of anterior and posterior vaginal wall prolapse in 26.0%, presence of external anal sphincter defect in the area of upper semicircle in 7.0% of patients. The use of a single-use hydrophosphate enema for preparation for minor rectal surgery has shown its effectiveness and high compliance (96.3%).

CONCLUSION

Women of late reproductive age with proctologic diseases have a combination of somatic and gynecologic diseases, a high percentage (51.9%) of undiagnosed pelvic floor dysfunction. Patients with a history of two or more spontaneous births, birth trauma of the perineum, body weight deficiency, constipation presents the group of risk. The ultrasound method is the most informative for early diagnosis of pelvic floor dysfunction. Disposable sterile hydrophosphate enemas should be considered an effective and convenient method of rectal preparation for small surgical interventions.