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Rectoanal inhibition and rectocele: physiology versus categorization
A P Zbar1, M Beer-Gabel, M Aslam
1Academic Department of Colorectal Surgery, Imperial College School of Science Technology and Medicine, London, UK. apzbar@zahav.net.il
International Journal of Colorectal Disease
|November 1, 2001
Summary
This study found few physiological differences between rectocele types, regardless of pelvic organ prolapse. Rectocele patients showed some manometric variations compared to controls, but not significantly between rectocele types.
Area of Science:
- Gastroenterology and Pelvic Floor Disorders
- Anorectal Physiology
Background:
- Rectocele classification often distinguishes between types with and without pelvic organ prolapse.
- Understanding physiological differences is crucial for targeted treatment.
Purpose of the Study:
- To investigate physiological distinctions between type 1 (isolated rectocele) and type 2 (rectocele with pelvic organ prolapse) rectoceles.
- To compare anorectal manometry and defecography parameters between rectocele types and controls.
Main Methods:
- Conventional and vector anorectal manometry.
- Parametric assessment of the rectoanal inhibitory reflex (RAIR).
- Defecography in 33 controls, 14 type 1, and 26 type 2 rectocele patients.
Main Results:
- Significant differences in resting pressure (maximal resting anal pressure, vector volume) between rectocele types and controls.
- Significant differences in squeeze parameters (maximal squeeze pressure, vector volume) only between rectocele types.
- Minimal differences in RAIR parameters, with some sphincter inhibition variations observed.
Conclusions:
- Few significant physiological differences exist between type 1 and type 2 rectoceles based on manometry and defecography.
- Rectocele classification by associated prolapse may not reflect distinct anorectal functional profiles.