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Chinese Journal of Digestion and Medical Imageology(Electronic Edition) ›› 2024, Vol. 14 ›› Issue (03): 229-234. doi: 10.3877/cma.j.issn.2095-2015.2024.03.009

• Original Article • Previous Articles    

Analysis of pelvic floor morphology and functional characteristics of female patients with obstructed defecation syndrome based on transperineal ultrasound and anorectal manometry

Jingjing Li1, Qian Chen2, Huifen Zhou2, Yusha Zeng1, Xinyi Xu1, Zhimin Fan2, Yahong Xue2,()   

  1. 1. Graduate School, Nanjing University of Traditional Chinese Medicine, Nanjing 210023, China
    2. Department of Anorectal Diseases, Nanjing Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Traditional Chinese Medicine, Nanjing 210001, China
  • Received:2023-11-19 Online:2024-06-01 Published:2024-06-05
  • Contact: Yahong Xue

Abstract:

Objective

To analyze the morphology and functional characteristics of the pelvic floor in female with obstructed defecation syndrome (ODS) by using transperineal ultrasound (TPUS) and high-resolution anorectal manometry (HR-ARM).

Methods

From June 2019 to December 2021, the results of TPUS and HR-ARM about 117 female patients with ODS in the Department of Anorectal Diseases of Nanjing Hospital of Traditional Chinese Medicine were retrospectively analyzed, and the results of rectocele, rectal intussusception, enterocele, perineal descent, dyssynergic defecation, and anorectal pressure were evaluated.

Results

The types of defecation disorder diagnosed by TPUS was rectocele with rectal intussusception (RC+RI) in 29 cases (24.8%), followed by dyssynergic defecation (DD) in 14 cases (12.0%) and RC+RI+DD in 14 cases (12.0%). The results of HR-ARM showed that about 93.1% of patients had abnormal anorectal pressure distribution during simulated bowel movements, and the largest clinical classification was type Ⅳ DD in 28 cases (23.9%), followed by type Ⅱ DD in 25 cases (21.4%). There were 19 (16.2%) patients with rectal hypersensitivity and 13 (11.1%) patients with rectal hyposensitivity. The common structural abnormalities (DD, RC, and RI) diagnosed by TPUS were often accompanied by different types of anorectal coordination disorders and rectal sensory dysfunction.

Conclusion

The combination of TPUS and HR-ARM can better evaluate the morphological and functional characteristics of female patients with ODS, and is more conducive to guiding clinicians to formulate individualized treatment plans for such patients.

Key words: Obstructed defecation syndrome, Ultrasonography, transperineal, Anorectal manometry, Anatomy, Function

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