Assessing Rectocele Depth and Its Association with Symptoms of Pelvic Floor Disorders Using 2D Transperineal Ultraound

다국어 초록 (Multilingual Abstract)

We investigated the clinical features of symptomatic rectoceles, as measured by transperineal ultrasound (TPUS), and evaluated the association between rectocele size and the clinical symptoms of pelvic floor disorders. This was a retrospective study using data obtained at a pelvic floor center between August 2020 and January 2021. A total of 125 patients with defecation disorders, such as constipation and fecal incontinence, were included. The preoperative questionnaire included the Cleveland Clinic Constipation Scoring System (CCCS, Wexner constipation score), Cleveland Clinic Incontinence Score (CCIS, Wexner incontinence score), fecal incontinence severity index (FISI), and fecal incontinence quality of life (FIQOL) scale. The size of the rectocele was measured on 2D-TPUSimages. Patients were assigned to three groups based on rectocele size: no rectocele (<10 mm), ≥10 mm rectocele, and ≥15 mm rectocele. In the study population, 43 participants (34.4%) had no rectocele, 50 (40.0%) had ≥10 mm rectocele, and 32 (25.6%) had ≥15 mm rectocele. With the increase in the size of the rectocele from the no rectocele to ≥15 mm rectocelegroup, the scores for the symptoms of incontinence and constipation increased, and the quality of life worsened. The increase in the scores for the three groups was as follows: CCIS (6.00 ± 4.95 vs. 8.62 ± 5.77 vs. 11.08 ± 5.63, P = 0.004), FIQOL (13.72 ± 4.19 vs. 13.42 ± 4.35 vs. 10.38 ± 3.88, P = 0.006), FISI (18.83 ± 17.67 vs. 25.15 ± 17.34 vs. 33.42 ± 15.49, P = 0.010), and CCCS (7.50 ± 6.26 vs. 8.65 ± 5.31 vs. 13.11 ± 5.90, P = 0.006), respectively. TPUS is a valuable method for the anatomical evaluation of symptomatic rectocele. The larger the size of the symptomatic rectocele measured using TPUS, the more severe were the clinical symptoms.

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