ArticleInternational urogynecology journal2015
How large does a rectocele have to be to cause symptoms? A 3D/4D ultrasound study.
Article in International urogynecology journal, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 36 citations in OpenAlex.
- Magnetoelectric biofeedback for precision-targeted rectocele management: A randomized controlled trial of phenotype-driven pelvic floor neuromodulation.International journal of colorectal disease · 2026Trial
- IUGA Opinion Paper on Obstructed Defecation: Management of Clinical and Proctographic Rectoceles.International urogynecology journal · 2026Review
- International Urogynecological Consultation Chapter 2.2: Imaging in the Diagnosis of Pelvic Organ Prolapse.International urogynecology journal · 2025Review
- Ultrasound Quantitative Assessment of the Effects of Yoga on Early Postpartum Pelvic Organ Position Recovery.International urogynecology journal · 2025Article
- Rectocele: Incidental or important? Observe or operate? Contemporary diagnosis and management in the multidisciplinary era.Neurogastroenterology and motility · 2022Review
- Does the presence of a true radiological rectocele increase the likelihood of symptoms of prolapse?International urogynecology journal · 2021Article
- Rectal-vaginal pressure gradient in patients with pelvic organ prolapse and symptomatic rectocele.BMC women's health · 2021Article
- Long-term subjective, clinical and sonographic outcomes after native-tissue and mesh-augmented posterior colporrhaphy.International urogynecology journal · 2019Article
- Comparison of measurement systems for posterior vaginal wall prolapse on magnetic resonance imaging.International urogynecology journal · 2019Article
- Rectoanal intussusception is very common in patients with fecal incontinence.Journal of the anus, rectum and colon · 2018Article
- What is normal bladder neck anatomy?International urogynecology journal · 2016Article
- Anterior intussusception descent during defecation is correlated with the severity of fecal incontinence in patients with rectoanal intussusception.Techniques in coloproctology · 2016Article
- Does childbirth play a role in the etiology of rectocele?International urogynecology journal · 2015Article
- Translabial ultrasound in the assessment of pelvic floor and anorectal function in women with defecatory disorders.Techniques in coloproctology · 2014Review
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Authors and funding
4 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionRectocele is a common condition, which on imaging is defined by a pocket identified on Valsalva or defecation. Cut-offs of 10 and 20 mm for pocket depth have been described. This study analyses the correlation between rectocele depth and symptoms of bowel dysfunction to define a cut-off for the diagnosis of "significant rectocele" on ultrasound.
methodsA retrospective study using 564 archived data sets of patients seen at tertiary urogynaecological clinics. Patients underwent a standardised interview including a set of questions regarding bowel function, and translabial 3D/4D ultrasound. Assessments were undertaken supine and after voiding. Rectocele depth was measured on Valsalva.
resultsOut of 564, data on symptoms was missing in 18 and ultrasound volumes in 25, leaving 521. Mean age was 56 years (range 18-86), mean BMI 29 (17-56). Presenting symptoms were prolapse (51 %), constipation (21 %), vaginal digitation (17 %), straining at stool (46 %), incomplete bowel emptying (41 %) and faecal incontinence (10 %). A clinically significant rectocele (ICS POPQ stage ≥2) was found in 48 % (n=250). In 261 women a rectal diverticulum was identified, of an average depth of 17 (SD, 7) mm. On ROC statistics a cut- off of 15 mm in depth provided optimal sensitivities of 66 % for vaginal digitation and 63 % for incomplete emptying, and specificities of 52 and 57 % respectively.
conclusionsRectocele depth is associated with symptoms of obstructed defecation. A "clinically significant" rectocele may be defined as a diverticulum of the rectal ampulla of ≥15 mm in depth, although poor test characteristics limit clinical utility of this cut-off.
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