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Patients with suspected DD who met the Rome IV criteria were divided into the DD group and other types of constipation groups. The differences between the two groups were analyzed to explore the precise diagnostic scheme for DD.
This study was conducted solely at the Army Specialized Medical Center and was a single-center, bidirectional cohort study. Patients with suspected dyssynergic defecation who visited the constipation specialty clinic of Daping Hospital were collected. After the patients signed the informed consent form, they were asked to fill out the questionnaire (general clinical data questionnaire, Wexner constipation rating scale, ODS rating scale, and constipation patient quality of life scale (PAC-QOL)). The baseline data of the patients (such as age, gender, symptoms, constipation scale scores, intestinal satisfaction scores, etc.) and the results of anorectal manometry, defecography, and perineal ultrasound were statistically analyzed. Patients meeting the Rome IV criteria were grouped through DFG, ARM, and pelvic floor ultrasound examination. The differences in clinical main symptoms, constipation scores, defecography, perineal ultrasound, etc. between the two groups were observed, and the roles and correlations of each parameter in diagnosis were analyzed.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| patients with suspected PRS-related DD |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Analysis of inter-group differences | Other | Analysis of inter-group differences |
|
| Measure | Description | Time Frame |
|---|---|---|
| Rectal emptying rate，（%） | Rectal emptying rate is defined as the reduction in rectal area from pre-evacuation to post-evacuation, expressed as a percentage of the pre-evacuation area, as assessed by defecography. | Baseline assessment |
| Measure | Description | Time Frame |
|---|---|---|
| Obstructed Defecation Syndrome score，（ODS score） | the minimum value is 0,and maximum value is 31; a higher scores mean a worse outcome. | Baseline assessment |
| Cleveland Clinic Constipation Score,(CCCS) |
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Inclusion Criteria:
Exclusion Criteria:
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patients with suspected PRS-related DD
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| Name | Affiliation | Role |
|---|---|---|
| Weidong Tong, MD | Army Medical Center (Daping Hospital) | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Army Medical Center (Daping Hospital) | Yuzhong | Chongqing Municipality | 400042 | China |
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the minimum value is 0,and maximum value is 30; a higher scores mean a worse outcome.
| Baseline assessment |
| Patient Assessment of Constipation Quality of Life total score，（PAC-QOL score） | the minimum value is 0,and maximum value is 112; a higher scores mean a worse outcome. | Baseline assessment |
| Self-Rating Anxiety Scale score，（SAS score） | the minimum value is 25,and maximum value is 100; a higher scores mean a worse outcome. | Baseline assessment |
| Bristol Stool Form Scale score | the minimum value is 1,and maximum value is 7; a higher scores mean a worse outcome. | Baseline assessment |
| Body Mass Index | Baseline assessment |
| Disease duration,(year) | Baseline assessment |
| ARA change on DFG，(°) | changes in anorectal angle during defecography | Baseline assessment |
| Anal canal diameter on DFG，（mm） | anal canal diameter during straining on DFG | Baseline assessment |
| PRS on DFG | Puborectalis syndrome indicated by the defecography diagnostic report. | Baseline assessment |
| IRP on DFG | Internal rectal prolapse indicated by the defecography diagnostic report. | Baseline assessment |
| Rectocele on DFG | Rectocele indicated by the defecography diagnostic report. | Baseline assessment |
| Anal Resting Pressure，（mmHg） | Anal Resting Pressure measured by High-resolution Anorectal Manometry | Baseline assessment |
| Anal Squeeze Pressure,(mmHg) | Anal Squeeze Pressure measured by High-resolution Anorectal Manometry | Baseline assessment |
| Rectal propulsive pressure,(mmHg) | Rectal propulsive pressure measured by High-resolution Anorectal Manometry | Baseline assessment |
| Anal relaxation rate,(%) | Anal relaxation rate measured by High-resolution Anorectal Manometry during defecation | Baseline assessment |
| DD on HR-ARM | Dyssynergic defecation(DD) reported by high-resolution anorectal manometry parameters, with diagnostic criteria of rectal pressure during straining >45mmHg and anal canal relaxation rate <20%. | Baseline assessment |
| ARA change on TPUS,(°) | changes in anorectal angle during evacuation measured by Transperineal Ultrasound | Baseline assessment |
| Right PRM thickness change on TPUS,(mm) | Changes in right puborectalis muscle thickness during defecation measured by Transperineal Ultrasound | Baseline assessment |
| Left PRM thickness change on TPUS,(mm) | Changes in left puborectalis muscle thickness during defecation measured by Transperineal Ultrasound | Baseline assessment |
| PRS on TPUS | Puborectalis syndrome(PRS) indicated by the transperineal ultrasound diagnostic report | Baseline assessment |