Clinical significance of obstructive defecatory symptoms in women with pelvic organ prolapse

OBJECTIVE: To determine whether the presence of obstructive defecatory symptoms is associated with the site and severity of pelvic organ prolapse. METHODS: A cross-sectional study was performed of women with pelvic organ prolapse of grade 2 or greater who had completed a validated questionnaire that surveyed pelvic floor symptoms. Associations between patient characteristics, site and severity of prolapse, and obstructive bowel symptoms were investigated. RESULTS: Among 260 women with pelvic organ prolapse, women with posterior vaginal wall prolapse were more likely to report obstructive symptoms, such as incomplete emptying (41% vs 21%, P=0.003), straining at defecation (39% vs 19%, P=0.002), and splinting with defecation (36% vs 14%, P<0.001) compared with women without posterior vaginal wall prolapse. There was no significant association between any bowel symptom and increasing severity of prolapse. CONCLUSIONS: Obstructive bowel symptoms are significantly associated with the presence of posterior vaginal wall prolapse, but not with the severity of prolapse.