The Association Between Stage II or Greater Posterior Prolapse and Bothersome Obstructive Bowel Symptoms

Objective: The primary objective of this study was to estimate the association between stage II or greater posterior prolapse and individual obstructive bowel symptoms. Methods: We conducted a cross-sectional study of all women presenting for initial visit at a tertiary center for pelvic floor disorders. Exposure was defined as stage II or greater posterior vaginal prolapse as measured by pelvic organ prolapse quantification measurements. Outcomes included the separate bothersome obstructive bowel symptoms of splinting, straining, or incomplete bowel emptying. Results: Our study included 721 women. Univariate analysis did not show an association between stage II or greater posterior prolapse and the bothersome symptoms of straining or incomplete emptying. Stage II or greater posterior prolapse was associated with bothersome splinting (adjusted OR, 1.63; 95% CI, 1.06–2.53). Conclusions: Stage II or greater posterior prolapse was associated with the bothersome symptom of splinting, but not bothersome straining or the sensation of incomplete evacuation.

[1]  Morton B. Brown,et al.  Bowel symptoms in women 1 year after sacrocolpopexy. , 2008, American journal of obstetrics and gynecology.

[2]  S. Hart,et al.  Obstructive Defecation in Middle-aged Women , 2008, Digestive Diseases and Sciences.

[3]  S. Hart,et al.  The Constipation Severity Instrument: A Validated Measure , 2008, Diseases of the colon and rectum.

[4]  K. Guire,et al.  Symptoms of anal incontinence and difficult defecation among women with prolapse and a matched control cohort. , 2007, American journal of obstetrics and gynecology.

[5]  N. Hyman,et al.  Practice Parameters for the Evaluation and Management of Constipation , 2007, Diseases of the colon and rectum.

[6]  L. Spazzafumo,et al.  Set‐up and statistical validation of a new scoring system for obstructed defaecation syndrome , 2007, Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland.

[7]  Morton B. Brown,et al.  Bowel symptoms in women planning surgery for pelvic organ prolapse. , 2006, American journal of obstetrics and gynecology.

[8]  M. Barber,et al.  Rectocele repair: a randomized trial of three surgical techniques including graft augmentation. , 2006, American journal of obstetrics and gynecology.

[9]  B. Gurland,et al.  Posterior vaginal wall prolapse does not correlate with fecal symptoms or objective measures of anorectal function. , 2006, American journal of obstetrics and gynecology.

[10]  M. Barber,et al.  Short forms of two condition-specific quality-of-life questionnaires for women with pelvic floor disorders (PFDI-20 and PFIQ-7). , 2005, American journal of obstetrics and gynecology.

[11]  L. Brandt.  Thank You for Taking the Time to Listen to Me: A Reflection on Clinical Practice in the Era of Patient Consumerism , 2005, The American Journal of Gastroenterology.

[12]  C. R. Breitkopf,et al.  Pelvic Organ Support Study (POSST) and bowel symptoms: straining at stool is associated with perineal and anterior vaginal descent in a general gynecologic population. , 2005, American journal of obstetrics and gynecology.

[13]  E. Lukacz,et al.  Predictive value of prolapse symptoms: a large database study , 2005, International Urogynecology Journal.

[14]  G. Cundiff,et al.  Evaluation and Treatment of Women With Rectocele: Focus on Associated Defecatory and Sexual Dysfunction , 2004, Obstetrics and gynecology.

[15]  C. Pieper,et al.  Psychometric evaluation of 2 comprehensive condition-specific quality of life instruments for women with pelvic floor disorders. , 2001, American journal of obstetrics and gynecology.

[16]  R. Lipton,et al.  Epidemiology of constipation (EPOC) study in the United States: relation of clinical subtypes to sociodemographic features , 1999, American Journal of Gastroenterology.

[17]  A. Weber,et al.  Posterior vaginal prolapse and bowel function. , 1998, American journal of obstetrics and gynecology.

[18]  S. Lewis,et al.  Stool form scale as a useful guide to intestinal transit time. , 1997, Scandinavian journal of gastroenterology.

[19]  W. Hop,et al.  Role of defecography in predicting clinical outcome of rectocele repair , 1997, Diseases of the colon and rectum.

[20]  L. Brubaker,et al.  The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. , 1996, American journal of obstetrics and gynecology.

[21]  An evidence-based approach to the management of chronic constipation in North America. , 2005, The American journal of gastroenterology.

[22]  P. Schoenfeld,et al.  An Evidence-Based Approach to the Management of Chronic Constipation in North America , 2005, The American Journal of Gastroenterology.

[23]  G. Cundiff,et al.  Proceedings of the American Urogynecologic Society Multidisciplinary Symposium on Defecatory Disorders. , 2000, American journal of obstetrics and gynecology.