Annals of Coloproctology

Display

Sort by :

Original Articles

Clinical Significance of Perineal Descent in Pelvic Outlet Obstruction Diagnosed by using Defecography: Hyun Nam Baek, Yong Hee Hwang, Yong Hwan Jung; J Korean Soc Coloproctol. 2010;26(6):395-401. Published online December 31, 2010; DOI: https://doi.org/10.3393/jksc.2010.26.6.395

7,866 View
46 Download
20 Citations

Purpose

The aim of this study was to evaluate the clinical significance of perineal descent (PD) in pelvic outlet obstruction patients diagnosed by using defecography.

Methods

One hundred thirty-six patients with pelvic outlet obstruction (POO; median age 49 years) had more than one biofeedback session after defecography. Demographic finding, clinical bowel symptoms and anorectal physiological studies were compared for PD at rest and PD with dynamic changes.

Results

Age (r = 0.33; P < 0.001), rectocele diameter (r = 0.31; P < 0.01), symptoms of incontinence (P < 0.05) and number of vaginal deliveries (r = 0.46; P < 0.001) were correlated with increased fixed PD. However, the female gender (P < 0.005), rectal intussusceptions (P < 0.05), negative non-relaxing puborectalis syndrome (P < 0.00005) and rectocele (P < 0.0005) were correlated with increased dynamic PD. Duration of symptoms, number of bowel movements, history of pelvic surgery and difficult defecation were not related with PD. There was no significant correlation between fixed and dynamic PD and success of biofeedback therapy.

Conclusion

Age, vaginal delivery and diameter of the rectocele are associated with increased fixed PD. Female gender, rectal intussusceptions and a rectocele are correlated with increased dynamic PD. Biofeedback is an effective option for POO regardless of severity of PD.

Citations

Citations to this article as recorded by

Influence of Pubovisceral Avulsion on Perineal Body Descent and Prolapse Development
Durwash Badr, Liam C. Martin, Henry Chill, Alireza Hadizadeh, Ghazaleh Rostaminia, Steven D. Abramowitch
International Urogynecology Journal.2026; 37(5): 1317. CrossRef
Early outcomes of transverse perineal support in obstructed defecation syndrome with pathological perineal descent; a prospective cohort study
Haitham M. Azmy Basiouny, Ali Ahmed Shafik, Mohamed Yehia Elbarmelgi, Osama Refaie, Mohamed Tamer, Mahmoud Adel Abu Alwafa, Ahmed Mohamed Abdelaal
BMC Surgery.2026;[Epub] CrossRef
Diagnostic performance of three-dimensional high-resolution anorectal manometry in identifying descending perineal syndrome
Hua Chu, You Wang, Chunrong Ma, Lijun Du
Frontiers in Medicine.2026;[Epub] CrossRef
Evaluation of Perineal Descent Measurements on Pelvic Floor Imaging
Isabelle M. A. van Gruting, Kirsten Kluivers, Aleksandra Stankiewicz, Joanna IntHout, Kim W. M. van Delft, Ranee Thakar, Abdul H. Sultan
Journal of Clinical Medicine.2025; 14(2): 548. CrossRef
Association of body composition with the symptoms of pelvic floor disorders in middle-aged women: a longitudinal study
Mari A. Kuutti, Enni-Maria Hietavala, Hanna-Kaarina Juppi, Sarianna Sipilä, Pauliina Aukee, Eija K. Laakkonen
Menopause.2025; 32(9): 810. CrossRef
Enhancing clinical practice: The role of digital rectal examination in diagnosing functional defecation disorders
Lian-Jun Zhu, Xing-Lin Zeng, Xiang-Dong Yang
World Journal of Gastrointestinal Surgery.2025;[Epub] CrossRef
Transverse perineal support improves long-term outcomes in patients undergoing stapled transanal rectal resection for obstructed defecation syndrome: a multicenter observational case-control study
Adolfo Renzi, Luigi Marano, Pasquale Talento, Luigi Brusciano, Angela Pezzolla, Domenico Izzo, Carmine Antropoli, Francesco D’Aniello, Giandomenico Di Sarno, Gianluca Minieri, Grazia Cantore, Gianmattia Terracciano, Domenico Barbato, Ludovico Docimo, Mass
Annals of Coloproctology.2025; 41(4): 330. CrossRef
Rectal prolapse (62.2, 62.3), adults
Yu. A. Shelygin, S. I. Achkasov, D. V. Alyoshin, O. M. Biryukov, V. S. Groshilin, V. N. Kashnikov, I. V. Kostarev, N. V. Kostenko, A. I. Moskalev, A. A. Mudrov, A. V. Muravyov, N. V. Oleinik, V. V. Polovinkin, V. M. Тimerbulatov, A. Yu. Titov, O. Yu. Fome
Koloproktologia.2024; 23(3): 10. CrossRef
Rectal prolapse (62.2, 62.3), adults
Yu. A. Shelygin, S. I. Achkasov, D. V. Alyoshin, O. M. Biryukov, V. S. Groshilin, V. N. Kashnikov, I. V. Kostarev, N. V. Kostenko, A. I. Moskalev, A. A. Mudrov, A. V. Muravyov, N. V. Oleinik, V. V. Polovinkin, V. M. Тimerbulatov, A. Yu. Titov, O. Yu. Fome
Koloproktologia.2024; 23(3): 10. CrossRef
The role of obesity on urinary incontinence and anal incontinence in women: a review
SK Doumouchtsis, J Loganathan, V Pergialiotis
BJOG: An International Journal of Obstetrics & Gynaecology.2022; 129(1): 162. CrossRef
The Digital Rectal Examination
Gregory S. Sayuk
Gastroenterology Clinics of North America.2022; 51(1): 25. CrossRef
Consensus Definitions and Interpretation Templates for Fluoroscopic Imaging of Defecatory Pelvic Floor Disorders
Ian Paquette, David Rosman, Rania El Sayed, Tracy Hull, Ervin Kocjancic, Lieschen Quiroz, Susan Palmer, Abbas Shobeiri, Milena Weinstein, Gaurav Khatri, Liliana Bordeianou
Techniques in Coloproctology.2021; 25(1): 3. CrossRef
Consensus Definitions and Interpretation Templates for Fluoroscopic Imaging of Defecatory Pelvic Floor Disorders
Ian Paquette, David Rosman, Rania El Sayed, Tracy Hull, Ervin Kocjancic, Lieschen Quiroz, Susan Palmer, Abbas Shobeiri, Milena Weinstein, Gaurav Khatri, Liliana Bordeianou
Diseases of the Colon & Rectum.2021; 64(1): 31. CrossRef
Consensus Definitions and Interpretation Templates for Fluoroscopic Imaging of Defecatory Pelvic Floor Disorders Proceedings of the Consensus Meeting of the Pelvic Floor Consortium of the American Society of Colon and Rectal Surgeons, the Society of Abdom
Ian Paquette, David Rosman, Rania El Sayed, Tracy Hull, Ervin Kocjancic, Lieschen Quiroz, Susan Palmer, Abbas Shobeiri, Milena Weinstein, Gaurav Khatri, Liliana Bordeianou
Female Pelvic Medicine & Reconstructive Surgery.2021; 27(1): e1. CrossRef
European society of neurogastroenterology and motility guidelines on functional constipation in adults
Jordi Serra, Daniel Pohl, Fernando Azpiroz, Giuseppe Chiarioni, Philippe Ducrotté, Guillaume Gourcerol, A. Pali S. Hungin, Peter Layer, Juan‐Manuel Mendive, Johann Pfeifer, Gerhard Rogler, S. Mark Scott, Magnus Simrén, Peter Whorwell
Neurogastroenterology & Motility.2020;[Epub] CrossRef
Pathophysiology of the functional constipation in elderly
Michael D. Levin
Pelviperineology.2019; : 53. CrossRef
Systematic review with meta‐analysis: defecography should be a first‐line diagnostic modality in patients with refractory constipation
Ugo Grossi, Gian Luca Di Tanna, Henriette Heinrich, Stuart A. Taylor, Charles H. Knowles, S. Mark Scott
Alimentary Pharmacology & Therapeutics.2018; 48(11-12): 1186. CrossRef
Defecatory Dysfunction and the Pelvic Floor
Ajay Rane, Sapna Dilgir
Current Obstetrics and Gynecology Reports.2017; 6(3): 237. CrossRef
Defecographic Findings in Patients with Severe Idiopathic Chronic Constipation
Rahmatollah Rafiei, Azadeh Bayat, Masoud Taheri, Zahra Torabi, Lotfollah Fooladi, Saideh Husaini
The Korean Journal of Gastroenterology.2017; 70(1): 39. CrossRef
Descending perineum syndrome: a review of the presentation, diagnosis, and management
Zaid Chaudhry, Christopher Tarnay
International Urogynecology Journal.2016; 27(8): 1149. CrossRef

Prognostic Factors Associated with Poor Outcome of Biofeedback Therapy for Constipated Patients with Pelvic Outlet Obstruction.: Kim, Sung Jin , Hwang, Yong Hee , Jung, Yong Hwan; J Korean Soc Coloproctol. 2008;24(5):313-321.; DOI: https://doi.org/10.3393/jksc.2008.24.5.313

2,249 View
11 Download

Abstract PDF: PURPOSE
The aim of this study was to identify the prognostic factors associated with poor outcome of biofeedback therapy.
METHODS
One hundred thirty-seven (137) constipated patients with pelvic outlet obstruction (median age 49 years) had more than one biofeedback session after defecography. Follow-up data (mean follow-up: 14 months; range: 2~37 months) were obtained in 114 patients. Any differences in demographics, clinical symptoms, and parameters of an anorectal physiological study were evaluated between the success group and the failure group.
RESULTS
At follow-up, 80 (70 percent) patients felt improvement in symptoms, but 34 (30 percent) patients did not. Pre-biofeedback presence of symptoms of difficult defecation predict poor outcome (88 vs. 69 percent for failure vs. success, P<0.05). The positive and the negative predictive values of difficult defecation for poor outcome were 35 percent and 86 percent, respectively. A negative mean pressure change on pre-biofeedback anal manometry was related to a poor outcome (65 vs. 26 percent for failure vs. success, P<0.001). The positive and the negative predictive values of negative mean pressure change for poor outcome were 51 percent and 83 percent, respectively. A negative electrical current change on pre-biofeedback anal electromyography was related to a poor outcome (23 vs. 9 percent for failure vs. success, P<0.05). The positive and the negative predictive values of negative electrical-current change for poor outcome were 53 percent and 74 percent, respectively.
CONCLUSIONS
Difficult defecation, negative mean pressure change in pre-biofeedback anal manometry, and negative electrical current change in pre-biofeedback anal electromyography were predictors associated with poor outcome of biofeedback therapy for constipated patients with pelvic outlet obstruction.

Physiologic Characteristics and its Clinical Significances in the Patients with Pelvic Outlet Obstruction.: Park, Ung Chae , Chung, Soon Sup , Park, Seung Hwa; J Korean Soc Coloproctol. 2000;16(4):215-222.

1,501 View
5 Download

Abstract PDF: Current study was designed to assess the functional etiology of patients with pelvic outlet obstruction. Moreover, physiologic characteristics and theirs clinical significances were evaluated in the patients with ramified diagnosis.
METHODS
172 patients with pelvic outlet obstruction were performed 328 numbers of physiologic studies. These included cinedefecography (n=172), anal manometry (n=87), colonic transit time study (n=38), and anal EMG/PNTML (n=31). On the basis of physiologic findings, patient groups were categorized as rectocele (group I), nonrelaxing puborectalis syndrome (group II), anal dyschezia (group III), and rectoanal intussusception (group IV). The physiologic findings were compared between subgroup patients.
RESULTS
Incidence of categorized patients was 51.7% (group I, n=89), 22.7% (group II, n=39), 12.2% (group III, n=21), and 8.7% (group IV, n=15), respectively. The mean age of patients with group III were lower (p<0.05) than that of overall patients. The incidence of female patients was higher in group I and the incidence of male patients was higher in group II (p<0.0001). In cinedefecography, patients with group II showed smaller anorectal angle at strain (p<0.001), at dynamic change between rest and strain (p=0.002). In anal manometry, patients with group III showed higher mean resting pressures (p=0.001), higher maximum resting pressures (p<0.001), higher mean squeeze pressures, and higher maximal voluntary contraction (p=0.003) than those of patients with other group. In neurologic study, mean value of PNTML was 2.32 +/- 0.34 (range, 1.60~3.66) msec in overall patients. The size of rectocele was increased in proportion to patient's age (r=0.229, p<0.05), number of delivery (r=0.393, p=0.001), and degree of perineal descent (r=0.231, p<0.05). The degree of perineal descent was increased in proportion to patient's age (r=0.249, p<0.05).
CONCLUSIONS
Present series provided the diagnostic ramification of pelvic outlet obstruction by using the anorectal physiologic investigations. In addition to the function of puborectalis muscle, evacuation dynamics of anorectum should be emphasized. These findings could provide the fundamental information for guideline of future therapy in the patients with obstructed defecation.

First
Prev
Page of 1
Next
Last

Search