Prevalence of rectocele in young nulliparous women

Dietz, H. P. and Clarke, B. (2005) Prevalence of rectocele in young nulliparous women. Australian & New Zealand Journal of Obstetrics & Gynaecology, 45 5: 391-394. doi:10.1111/j.1479-828X.2005.00454.x

Author Dietz, H. P.
Clarke, B.
Title Prevalence of rectocele in young nulliparous women
Journal name Australian & New Zealand Journal of Obstetrics & Gynaecology   Check publisher's open access policy
ISSN 0004-8666
Publication date 2005-10-01
Sub-type Article (original research)
DOI 10.1111/j.1479-828X.2005.00454.x
Volume 45
Issue 5
Start page 391
End page 394
Total pages 4
Editor M. Humphrey
Place of publication Carlton South, Australia
Publisher Blackwell Publishing Asia
Language eng
Subject C1
321014 Obstetrics and Gynaecology
730115 Urogenital system and disorders
1114 Paediatrics and Reproductive Medicine
Abstract Background: It is generally assumed that fascial defects in the rectovaginal septum are the result of childbirth. However, rectoceles do occur in women who have never delivered vaginally. Aims: To determine the incidence of rectocele in a cohort of asymptomatic, young nulliparous women. Methods: Observational cohort study on 178 nulliparous caucasian women (aged 18-24) recruited for a twin study of pelvic floor dysfunction. All women were interviewed and examined by translabial ultrasound, supine and after voiding. In 52 women, 3D imaging was obtained and 171 datasets were complete and available for analysis. Ultrasound findings were reviewed for rectovaginal septal integrity by an assessor blinded against interview and demographic data for rectovaginal septal integrity. Results: A discontinuity of the anterior rectal wall with extrusion of rectal mucosa or contents (depth of ! 10 mm) was observed in 21/171 (12%). The depth of this herniation ranged from 10 to 25 mm and was filled with stool (n = 10) or rectal mucosa (n = 11). Defects were associated with a higher BMI (P = 0.049), with the complaint of constipation (P = 0.049) and non-significantly with straining at stool (P = 0.09). Descent of the ampulla to beyond the level of the symphysis pubis without fascial defect, that is, significant perineal relaxation, was observed in 23/171 (13%). Conclusions: Twelve percent of 171 young nulligravid caucasian women showed a defect of the rectovaginal septum. Associations were observed with higher body mass index and a history of constipation. It is hypothesised that in some women defects of the rectovaginal septum and perineal hypermobility may be congenital in nature.
Keyword Obstetrics & Gynecology
3d Ultrasound
Pelvic Floor Trauma
Vaginal Delivery
Dynamic Transperineal Ultrasound
Pelvic Floor Ultrasound
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2006 Higher Education Research Data Collection
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 27 times in Thomson Reuters Web of Science Article | Citations
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Created: Wed, 15 Aug 2007, 15:43:04 EST