International Urogynecology Journal

, Volume 19, Issue 9, pp 1291–1297 | Cite as

Correlation between posterior vaginal wall defects assessed by clinical examination and by defecography

  • Annette G. Groenendijk
  • Victor P. van der Hulst
  • Erwin Birnie
  • Gouke J. Bonsel
Original Article
First Online:
Received:
Accepted:

Abstract

To estimate the accuracy of clinical examination and the indications for defecography in patients with primary posterior wall prolapse. Fifty-nine patients with primary pelvic organ prolapse were evaluated with a questionnaire, clinical examination and defecography. Defecography was used as reference standard. There was no relation between bowel complaints and posterior wall prolapse evaluated by clinical examination (p = 0.33), nor between bowel complaints and rectocele (p = 0.19) or enterocele (p = 0.99) assessed by defecography. The diagnostic accuracy of clinical examination in diagnosing rectocele was 0.42, sensitivity was 1.0 and specificity was 0.23. The diagnostic accuracy of clinical examination in diagnosing enterocele was 0.73, with a sensitivity of 0.07 and a specificity of 0.95. Clinical examination is not accurate to assess anatomic defects of the posterior vaginal wall. Defecography is recommended as a helpful diagnostic tool in the work-up of patients with posterior vaginal wall prolapse if surgical repair is considered.

Keywords

Posterior vaginal wall prolapse Defecography in pelvic organ prolapse Defecation disorders in pelvic organ prolapse 
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Notes

Acknowledgement

The authors would like to thank Jan-Paul W.R. Roovers, Academic Medical Center-University of Amsterdam, for his careful reading and his contribution to the revision of this article.

Conflicts of interest

None

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Copyright information

© International Urogynecology Journal 2008

Authors and Affiliations

  • Annette G. Groenendijk
    • 1
  • Victor P. van der Hulst
    • 2
  • Erwin Birnie
    • 3
    • 4
  • Gouke J. Bonsel
    • 3
    • 4
  1. 1.Department of Gynaecology and ObstetricsOnze Lieve Vrouwe HospitalAmsterdamThe Netherlands
  2. 2.Department of RadiologyOnze Lieve Vrouwe HospitalAmsterdamThe Netherlands
  3. 3.Department of Public Health EpidemiologyAcademic Medical Center—University of AmsterdamAmsterdamThe Netherlands
  4. 4.Institute of Health Policy and Management, Erasmus Medical CenterRotterdamThe Netherlands

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