The aim of the present study was to compare clinical and radiological findings when assessing posterior vaginal wall
prolapse. Defecography can be used to
complement the clinical evaluation in patients with posterior vaginal wall
prolapse. Further development of the defecography technique, using contrast medium in the urinary bladder and intraperitoneally, have resulted in cystodefecoperitoneography (
CDP). Thirty-eight women underwent clinical examination using the
pelvic organ prolapse quantification system (POP-Q) followed by
CDP. All patients answered a standardized bowel function questionnaire. Statistical analysis measuring correlation between POP-Q and
CDP using Pearson's correlation coefficient (r) and Spearman's rank order correlation coefficient (rs) demonstrated a poor to moderate correlation, r=0.49 and rs=0.55. Although there was a strong association between large
rectoceles (>3 cm) at
CDP and symptoms of rectal emptying difficulties (p<0.001), severity and prevalence of bowel dysfunction showed poor coherence with clinical
prolapse staging and findings at radiological imaging. Vaginal topography and POP-Q staging predict neither radiological size nor visceral involvement in posterior vaginal wall
prolapse. Radiological evaluation may therefore be a useful
complement in selected patients.