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Quantification of Levator Ani Hiatus Enlargement by Magnetic Resonance Imaging in Males and Females with Pelvic Organ Prolapse
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Rectal intussusception is associated with abnormal levator ani muscle structure and morphometry.

N Rodrigo1, K L Shek, H P Dietz

  • 1Sydney Medical School Nepean, Nepean Hospital, Penrith, NSW 2750, Australia.

Techniques in Coloproctology
|November 19, 2010
PubMed
Summary

Rectal intussusception (RI) affects nearly 4% of urogynaecology patients, often linked to pelvic floor issues. This condition is associated with symptoms like prolapse, incomplete bowel emptying, and fecal incontinence.

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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.