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Is there any association between symptoms and findings on imaging in pelvic floor defaecatory dysfunction? A prospective study
Author(s) -
Hainsworth Alison J.,
Solanki Deepa,
Morris Samantha J.,
Igbedioh Carlene,
Schizas Alexis M. P.,
Williams Andrew B.
Publication year - 2021
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.15396
Subject(s) - medicine , pelvic floor , prospective cohort study , observational study , ultrasound , defecation , radiology , surgery
Abstract Aim To compare features on imaging (integrated total pelvic floor ultrasound (transperineal, transvaginal) and defaecation proctography) with bowel, bladder and vaginal symptoms in pelvic floor defaecatory dysfunction. Method A prospective observational case series of 216 symptomatic women who underwent symptom severity scoring (bowel, bladder and vaginal), integrated total pelvic floor ultrasound and defaecation proctography. Anatomical (rectocele, intussusception, enterocele, cystocele) and functional (co‐ordination, evacuation) features were examined. Results Irrespective of imaging modality, patients with a rectocele had higher International Consultation on Incontinence Modular Questionnaire – Vaginal Symptoms (ICIQ‐VS) scores than patients without. On integrated total pelvic floor ultrasound, ICIQ‐VS quality of life scores were higher in those with a rectocele. There was a higher International Consultation on Incontinence Modular Questionnaire – Bowel Symptoms (ICIQ‐BS) bowel pattern score in those with a rectocele, and a lower ICIQ‐BS bowel pattern and sexual impact score in those with intussusception. Poor co‐ordination was associated with increased ICIQ‐BS bowel control scores and obstructed defaecation symptom scores. On defaecation proctography, ICIQ‐VS symptom scores were lower in patients with poor co‐ordination. Conclusion Patients with a rectocele on either imaging modality may have qualitative vaginal symptoms on assessment. In patients with bowel symptoms but no vaginal symptoms, it is not possible to predict which anatomical abnormalities will be present on imaging.