Rectocele-does the size matter?
Rectocele-does the size matter?
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DOI：
10.1007/s00384-012-1425-7
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发表时间：
2012-07-01
影响因子：
2.8
通讯作者：
Gabel, Marc Beer
中科院分区：
文献类型：
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作者：
Carter, Dan;Gabel, Marc Beer
大的直肠前突（> 2cm）被认为与排便困难、便秘、直肠疼痛和直肠出血有关。本研究的目的是确定直肠前突的大小是否与患者的症状或排便参数有关。我们对转诊到我们诊所评估排便障碍的患者进行了一项回顾性研究。所有患者均被询问便秘、大便失禁和肠易激综合征，并通过动态会阴超声检查和传统肛门直肠测压进行评估。106名（22%）妇女被诊断为直肠前突，93名（87%）妇女直肠前突直径> 2 cm。直肠前突大小与人口统计学资料、产次或患者症状无显著相关性。症状的严重程度与直肠前突的大小或位置无关。肠易激综合征的诊断与直肠前突的大小无关。直肠前突的位置、肠膨出的发生和肠套叠与直肠前突的大小无关。直肠前突完全排空在小直肠前突中更常见（79% vs. 24%，p = 0.0001），而直肠前突不排空在大直肠前突中更常见（37% vs. 0，p = 0.01）。直肠感觉减退和肛门不对称与直肠前突的大小无关，因此，只有直肠前突的排空与直肠前突的大小相关，但无临床意义。其他临床解剖因素也与直肠前突的大小无关。直肠前突的大小本身可能不是手术的指征。
Large rectoceles (> 2 cm) are believed to be associated with difficulty in evacuation, constipation, rectal pain, and rectal bleeding. The aim of our study was to determine whether rectocele size is related to patient's symptoms or defecatory parameters.We conducted a retrospective study on data collected on patients referred to our clinic for the evaluation of evacuation disorders. All patients were questioned for constipation, fecal incontinence, and irritable bowel syndrome and were assessed with dynamic perineal ultrasonography and conventional anorectal manometry.Four hundred eighty-seven women were included in our study. Rectocele was diagnosed in 106 (22%) women, and rectocele diameter > 2 cm in 93 (87%) women. Rectocele size was not significantly related to demographic data, parity, or patient's symptoms. The severity of the symptoms was not correlated to the size or to the position of the rectocele. The diagnosis of irritable bowel syndrome was neither related to the size of the rectocele. Rectocele location, occurrence of enterocele, and intussusception were not related to the size of the rectocele. Full evacuation of rectoceles was more common in small rectoceles (79% vs. 24%, p = 0.0001), and no evacuation was more common in large rectoceles (37% vs. 0, p = 0.01). Rectal hyposensitivity and anismus were not related to the size of the rectocele.In conclusion, only the evacuation of rectoceles was correlated to the size of the rectoceles, but had no clinical significance. Other clinical, anatomical factors were also not associated to the size of the rectoceles. Rectoceles' size alone may not be an indication for surgery.