IS BARIUM TRAPPING IN RECTOCELES SIGNIFICANT

PURPOSE: This study was designed to determine whether rectocele size a nd contrast retention are significant. METHODS: Evacuation proctograph y and simultaneous intrarectal pressure measurements from a small, non compliant balloon catheter were performed in. three matched groups of II constipated female patients with rectoceles, rectoceles and contras t trapping of >10 percent, and no rectocele. Computerized image analys is was used to measure rectocele area and evacuation RESULTS: In the t wo groups with rectoceles, there was no significant difference in rect ocele area or width pre-evacuation. The anorectal angle, pelvic floor descent, maximum anal canal width, evacuation time or completeness, ma ximum and distal intrarectal pressure, or need to digitate did not dif fer significantly between the groups. In seven patients with barium tr apping (64 percent) the intrarectal pressure dropped abruptly as the b alloon entered the rectocele, suggesting that trapping results from se questration into the vagina, closing part of the rectocele from the no rmal intrarectal pressure zone. CONCLUSION: Because no impairment of e vacuation appears to be associated with either a large rectocele or tr apping, these evacuation problems should not be directly attributed to these proctographic findings.