Rectal-vaginal pressure gradient in patients with pelvic organ prolapse and symptomatic rectocele.
Rectal-vaginal pressure gradient in patients with pelvic organ prolapse and symptomatic rectocele.
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DOI：
10.1186/s12905-021-01304-6
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发表时间：
2021-04-20
期刊：
影响因子：
--
通讯作者：
Yang X
中科院分区：
文献类型：
--
作者：
Tan C;Tan M;Geng J;Tang J;Yang X
本研究的目的是探讨盆腔器官脱垂（POP）患者的直肠阴道压力与症状性直肠前突之间的关系。根据POP定量分类方法，计划在2016-2019年接受盆底重建手术的III或IV期阴道后脱垂患者纳入本研究。直肠前突的诊断采用经唇超声，排便梗阻（OD）的诊断符合罗马IV诊断标准。在最大Vasalva下使用腹膜压力计测量直肠和阴道压力。为了确保稳定性，对每名患者进行三次测试。本研究共入组217例患者。68例患者在直肠壶腹深度为19 mm时诊断为真性直肠前突。此外，36例患者被诊断为OD。症状性直肠前突与年龄较大（p < 0.01）、OD症状评分较高（p < 0.001）和根尖脱垂程度较低（p < 0.001）显著相关。有症状性直肠前突患者的直肠-阴道压力梯度（37.4 ± 11.7 cm H2O）高于无症状性直肠前突患者（16.9 ± 8.4 cm H2O，p < 0.001）和无直肠前突患者（17.1 ± 9.2 cm H2O，p < 0.001）。直肠-阴道压力梯度是POP患者出现症状性直肠前突的危险因素，直肠-阴道压力梯度> 27.5 cm H2O可作为直肠-阴道压力梯度升高的分界点。
The aim of this study is to examine the relationship between rectal–vaginal pressure and symptomatic rectocele in patients with pelvic organ prolapse (POP). Patients with posterior vaginal prolapse staged III or IV in accordance with the POP Quantitation classification method who were scheduled for pelvic floor reconstructive surgery in the years 2016–2019 were included in the study. Rectocele was diagnosed using translabial ultrasound, and obstructed defecation (OD) was diagnosed in accordance with the Roma IV diagnostic criteria. Both rectal and vaginal pressure were measured using peritron manometers at maximum Vasalva. To ensure stability, the test was performed three times with each patient. A total of 217 patients were enrolled in this study. True rectocele was diagnosed in 68 patients at a main rectal ampulla depth of 19 mm. Furthermore, 36 patients were diagnosed with OD. Symptomatic rectocele was significantly associated with older age (p < 0.01), a higher OD symptom score (p < 0.001), and a lower grade of apical prolapse (p < 0.001). The rectal–vaginal pressure gradient was higher in patients with symptomatic rectocele (37.4 ± 11.7 cm H2O) compared with patients with asymptomatic rectocele (16.9 ± 8.4 cm H2O, p < 0.001), and patients without rectocele (17.1 ± 9.2 cm H2O, p < 0.001). The rectal–vaginal pressure gradient was found to be a risk factor for symptomatic rectocele in patients with POP. A rectal–vaginal pressure gradient of > 27.5 cm H2O was suggested as the cut-off point of the elevated pressure gradient.
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影响因子：
1.8
作者：
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通讯作者：
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影响因子：
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DOI：
10.1196/annals.1389.034
发表时间：
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期刊：
REPRODUCTIVE BIOMECHANICS
影响因子：
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