Clinical Significance of Perineal Descent in Pelvic Outlet Obstruction Diagnosed by using Defecography
백현남, 황용희, 정용환,
소속 상세정보
백현남 ( Baek Hyun-Nam )
Sahmyook Medical Center Department of Surgery
황용희 ( Hwang Yong-Hee )
Sahmyook Medical Center Department of Surgery
정용환 ( Jung Yong-Hwan )
Sahmyook Medical Center Department of Surgery
KMID : 0356720100260060395
Abstract
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.
키워드
Perineal descent; Pelvic outlet obstruction; Biofeedback
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