Are rectoceles the cause or the result of obstructed defaecation syndrome? A prospective anorectal physiology study

Aim To determine the relationship between obstructed defaecation syndrome (ODS) and rectoceles. Method From December 2007 to November 2011, all female patients with ODS were prospectively evaluated with full interview, clinical examination and anorectal physiology testing. The characteristics of patients with and without rectoceles were compared, and logistic regression was utilized to identify factors predictive of patients having a rectocele beyond the introitus. Results Of 239 patients with ODS, 90 (mean age: 52.3 ± 1.7 years) had a rectocele. Patients with rectoceles (R+) had a similar prevalence of incomplete emptying compared with patients with no rectocele (R−) (P ≥ 0.21), but only R+ patients reported splinting with defaecation (36.7% vs 0%; P