Analysis of anorectal manometry in 40 women with posterior vaginal prolapse

Abstract

To study abnormal defecation in patients with posterior vaginal prolapse combined with anorectal manometry. From Jan. 2008 to Nov. 2009, clinical documents and examination of anorectal manometry of 40 patients with posterior vaginal prolapse were studied retrospectively. Anal physiologic testing was performed for 40 patients. These patients were classified into group A (stage 0 and I posterior vaginal prolapse, represented normal) and group B (stage II-IV). Results of anorectal manometry, constipation and symptoms of defecation were compared. The average anal canal resting pressure and squeeze pressure of 40 patients were (40 ± 21) and (96 ± 33) mm Hg (1 mm Hg = 0. 133 kPa). In group A, the anal canal resting pressure and squeeze pressure were (37 ± 21) and (78 ± 43) mm Hg, rectal sensation threshold and rectal maximum volume were (106 ± 61) and (183 ± 51) ml. In group B, the anal canal resting pressure and squeeze pressure were (42 ± 21) and (102 ± 30) mm Hg, rectal sensation threshold and rectal maximum volume were (90 ± 44) and (171 ± 61) ml. Apart from maximum squeeze pressure (P = 0.039), the other clinical index did not show statistical difference (P > 0.05). Rectal sensation threshold, intended volume and maximum capacity of (116 ± 69), (170 ± 90), (191 ± 75) ml in patients with constipation were higher than (84 ± 31), (121 ± 37), (169 ± 45) ml in patients without constipation. In addition to maximum capacity (P = 0.281), the other clinical index reached statistical difference between patients with and without constipation (P < 0.05). Patients with defecation symptoms have higher rectal sensation threshold, intended volume and maximum capacity than those of patients without defecation symptoms. As gradually increased in the degree of prolapse, resting pressure and squeeze pressure tend to be increased, while the rectal sensation threshold and rectal maximum volume tend to be decreased. Patients with defecation symptoms and constipation have increased the initial feeling of volume and maximum tolerated volume.