Rectal intussusception is associated with abnormal levator ani muscle structure and morphometry

Area of Science:

• Urogynaecology
• Pelvic Floor Imaging
• Gastrointestinal Imaging

Background:

• Anorectal symptoms are frequent in urogynaecology patients.
• Rectal intussusception (RI) is an anorectal abnormality associated with these symptoms.
• RI may be linked to abnormal levator ani muscle anatomy and function.

Purpose of the Study:

• Determine the prevalence of RI in a tertiary urogynaecological population.
• Describe associated symptoms, signs, and ultrasound findings.
• Investigate the association between RI and pelvic floor anatomy/function.

Main Methods:

• Retrospective analysis of 967 women's records and imaging data from a tertiary urogynaecological clinic (May 2005 - March 2009).
• Rectal intussusception diagnosed via translabial ultrasound.
• Ultrasound findings analyzed against symptoms and levator ani muscle hiatal area.

Main Results:

• RI found in 3.9% of patients, more prevalent with increased age and vaginal parity.
• RI associated with prolapse symptoms, incomplete bowel emptying, vaginal digitation, and fecal incontinence.
• RI linked to enterocele, rectocele, increased hiatal area on Valsalva, and levator ani avulsion.

Conclusions:

• Rectal intussusception is a common finding in urogynaecology patients.
• RI can be asymptomatic but is associated with symptoms of vaginal prolapse, incomplete bowel emptying, vaginal digitation, and fecal incontinence.
• Abnormal levator ani structure and morphometry are associated with RI.