Implementation of a standardized digital rectal exam to improve the accuracy of rectocele diagnosis

Autor: Andrea K. Crane, Mary L. Jannelli, Ellen C. Wells, AnnaMarie Connolly, Catherine A. Matthews, Elizabeth J. Geller, Jacquia L. Fenderson, E.M. Myers
Rok vydání: 2014
Předmět:
Zdroj: International Urogynecology Journal. 26:107-111
ISSN: 1433-3023
0937-3462
DOI: 10.1007/s00192-014-2479-6
Popis: The standardized evaluation of posterior compartment prolapse using the Pelvic Organ Prolapse Quantification (POP-Q) system is limited. The primary objective of this study is to develop and validate the interexaminer reliability of a new system for assessing the posterior vaginal wall for the presence of a rectocele. This was a cross-sectional study of women presenting to an academic urogynecology clinic. Subjects underwent a routine pelvic examination that included a standard POP-Q followed by two Standardized Digital Rectal Exams (SDRE) by two different providers, each blinded to the other’s results. The SDRE measures the distance from the leading edge of a posterior bulge to the hymen with a finger in the distal rectum - first visually and then an actual measured distance using a marked cotton swab (Q-tip measurement). Correlations between examiners for the SDRE and the POP-Q were analyzed using Pearson's correlation coefficient (ρ). Eight attending and fellow urogynecologists examined 50 subjects. Mean age was 57.3 years, mean BMI 30.9 kg/m2, with an overall median POP-Q stage 2 (range 0–3), and median posterior POP-Q stage 1 (range 0–3). Overall, 54 % of women had a noteworthy rectocele by typical digital rectal exam. Interexaminer correlations with SDRE for both the visual assessment (ρ = 0.697, p
Databáze: OpenAIRE
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