Background: The aim of this study was to demonstrate the distribution of defecographic pelvic floor abnormalities in constipated female patients and to correlate these dysfunctions with the mode of delivery.
Methods: Two hundred and fifty-five female patients who underwent defecography for constipation from 2001 to 2008 were reviewed and pelvic floor abnormalities were assessed. The patients were divided into three groups: group I had 50 nulliparous women, mean age 40.2 (+ or - 15.3), group II had 165 vaginally parous women, mean age 57 (+ or - 13.3), and group III had 40 patients delivered by cesarean section, mean age 50.6 (+ or - 11.9).
Results: Significant rectocele was identified in group I (36%), group II (35.8%), and group III (20%) without any statistically significant differences among the groups (p > 0.05). Intussusception was identified in group I (48%), group II (70.3%), and in group III (67.5%; p = 0.014). Intussusception associated with significant rectocele was more common in vaginally parous patients (p = 0.043). Abnormalities on puborectalis relaxation associated or not associated with rectocele were similar among the groups (p = 0.47). Vaginally parous patients had more abnormal exams as compared to other patients (p = 0.005). Significant rectocele was identified in (39%) patients with age > or = 50 years and in (26.3%) patients with age <50 years (p = 0.03).
Conclusion: There was no specific correlation between distribution of pelvic floor disorders and mode of delivery in this study. Patients of age greater than 50 years had a higher incidence of significant rectocele.