{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T01:46:42Z","timestamp":1771033602507,"version":"3.50.1"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"9","license":[{"start":{"date-parts":[[2021,2,26]],"date-time":"2021-02-26T00:00:00Z","timestamp":1614297600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2021,2,26]],"date-time":"2021-02-26T00:00:00Z","timestamp":1614297600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int Urogynecol J"],"published-print":{"date-parts":[[2021,9]]},"DOI":"10.1007\/s00192-021-04734-w","type":"journal-article","created":{"date-parts":[[2021,2,26]],"date-time":"2021-02-26T13:03:34Z","timestamp":1614344614000},"page":"2377-2381","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Is perineal hypermobility an independent predictor of obstructive defecation?"],"prefix":"10.1007","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2211-6149","authenticated-orcid":false,"given":"Hans Peter","family":"Dietz","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Emilia","family":"Alcoba","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Talia","family":"Friedman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nishamini","family":"Subramaniam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,2,26]]},"reference":[{"issue":"6","key":"4734_CR1","doi-asserted-by":"publisher","first-page":"939","DOI":"10.1007\/s00192-015-2914-3","volume":"27","author":"R Guzman Rojas","year":"2016","unstructured":"Guzman Rojas R, Kamisan Atan I, Shek K, Dietz H. The prevalence of abnormal posterior compartment anatomy and its association with obstructed defecation symptoms in urogynecological patients. Int Urogynecol J. 2016;27(6):939\u201344.","journal-title":"Int Urogynecol J"},{"key":"4734_CR2","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1002\/uog.1930","volume":"26","author":"HP Dietz","year":"2005","unstructured":"Dietz HP, Steensma AB. Posterior compartment prolapse on two-dimensional and three-dimensional pelvic floor ultrasound: the distinction between true rectocele, perineal hypermobility and enterocele. Ultrasound Obstet Gynecol. 2005;26:73\u20137.","journal-title":"Ultrasound Obstet Gynecol"},{"key":"4734_CR3","first-page":"6","volume":"59","author":"A Parks","year":"1966","unstructured":"Parks A, Porter N, Hardcastle J. The syndrome of the descending perineum. Proc Royal Soc Med. 1966;59:6.","journal-title":"Proc Royal Soc Med"},{"issue":"1","key":"4734_CR4","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1111\/j.1572-0241.1999.00782.x","volume":"94","author":"G Harewood","year":"1999","unstructured":"Harewood G, Coulie B, Camilleri M, Rath-Harvey D, Pemberton J. Descending perineum syndrome: audit of clinical and laboratory features and outcome of pelvic floor retraining. Am J Gastroenterol. 1999;94(1):126\u201330.","journal-title":"Am J Gastroenterol"},{"key":"4734_CR5","doi-asserted-by":"publisher","first-page":"729","DOI":"10.1007\/s00192-012-1672-8","volume":"23","author":"V Chantarasorn","year":"2012","unstructured":"Chantarasorn V, Shek K, Dietz HP. Mobility of the perineal body and anorectal junction before and after childbirth. Int Urogynecol J. 2012;23:729\u201333.","journal-title":"Int Urogynecol J"},{"key":"4734_CR6","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1007\/s10151-010-0657-1","volume":"15","author":"N Rodrigo","year":"2011","unstructured":"Rodrigo N, Shek K, Dietz H. Rectal intussusception is associated with abnormal levator structure and morphometry. Tech Coloproctol. 2011;15:39\u201343.","journal-title":"Tech Coloproctol."},{"key":"4734_CR7","doi-asserted-by":"publisher","first-page":"50","DOI":"10.3389\/fsurg.2018.00050","volume":"5","author":"A Nessi","year":"2018","unstructured":"Nessi A, Kane A, Vincens E, Salet-Liz\u00e9e D, Lepigeon K, Villet R. Descending perineum associated with pelvic organ prolapse treated by sacral colpoperineopexy and retrorectal mesh fixation: preliminary results. Front Surg. 2018;5:50.","journal-title":"Front Surg"},{"key":"4734_CR8","doi-asserted-by":"publisher","first-page":"1149","DOI":"10.1007\/s00192-015-2889-0","volume":"27","author":"Z Chaudhry","year":"2016","unstructured":"Chaudhry Z, Tarnay C. Descending perineum syndrome: a review of the presentation, diagnosis, and management. Int Urogynecol J. 2016;27:1149\u201356.","journal-title":"Int Urogynecol J"},{"issue":"1","key":"4734_CR9","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1016\/S0002-9378(96)70243-0","volume":"175","author":"RC Bump","year":"1996","unstructured":"Bump RC, Mattiasson A, Bo K, Brubaker LP, DeLancey JO, Klarskov P, et al. The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol. 1996;175(1):10\u20137.","journal-title":"Am J Obstet Gynecol"},{"key":"4734_CR10","volume-title":"Sonography in obstetrics and gynecology: principles and practice","author":"HP Dietz","year":"2017","unstructured":"Dietz HP. Pelvic floor ultrasound. In: Fleischer A, editor. Sonography in obstetrics and gynecology: principles and practice. 8th ed. Columbus: McGraw Hill; 2017.","edition":"8"},{"key":"4734_CR11","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1016\/j.bpobgyn.2018.06.006","volume":"54","author":"H Dietz","year":"2019","unstructured":"Dietz H. Ultrasound in the assessment of pelvic organ prolapse. Best Pract Res Clin Obstet Gynecol. 2019;54:12\u201330.","journal-title":"Best Pract Res Clin Obstet Gynecol"},{"key":"4734_CR12","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1007\/s10151-015-1321-6","volume":"19","author":"F Pucciani","year":"2015","unstructured":"Pucciani F. Descending perineum syndrome: new perspectives. Tech Coloproctol. 2015;19:443\u20138.","journal-title":"Tech Coloproctol"},{"key":"4734_CR13","doi-asserted-by":"publisher","first-page":"1279","DOI":"10.1136\/gut.25.11.1279","volume":"25","author":"E Kiff","year":"1984","unstructured":"Kiff E, Barnes P, Swash M. Evidence of pudendal neuropathy in patients with perineal descent and chronic strain at stool. Gut. 1984;25:1279\u201382.","journal-title":"Gut."},{"key":"4734_CR14","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1002\/mus.20387","volume":"33","author":"J Lefaucher","year":"2006","unstructured":"Lefaucher J. Neurophysiological testing in anorectal disorders. Muscle Nerve. 2006;33:324\u201333.","journal-title":"Muscle Nerve"},{"key":"4734_CR15","doi-asserted-by":"publisher","first-page":"580","DOI":"10.1002\/uog.1899","volume":"25","author":"H Dietz","year":"2005","unstructured":"Dietz H, Shek K, Clarke B. Biometry of the pubovisceral muscle and levator hiatus by three-dimensional pelvic floor ultrasound. Ultrasound Obstet Gynecol. 2005;25:580\u20135.","journal-title":"Ultrasound Obstet Gynecol"},{"key":"4734_CR16","doi-asserted-by":"publisher","first-page":"1485","DOI":"10.1111\/j.1471-0528.2010.02704.x","volume":"117","author":"K Shek","year":"2010","unstructured":"Shek K, Dietz H. Intrapartum risk factors of levator trauma. Br J Obstet Gynaecol. 2010;117:1485\u201392.","journal-title":"Br J Obstet Gynaecol"},{"key":"4734_CR17","doi-asserted-by":"publisher","unstructured":"AIUM\/IUGA practice parameter for the performance of Urogynecological ultrasound examinations. Int Urogynecol J. 2019;30:1389\u2013400. https:\/\/doi.org\/10.1007\/s00192-019-03954-5.","DOI":"10.1007\/s00192-019-03954-5"},{"key":"4734_CR18","doi-asserted-by":"crossref","unstructured":"Melon J, Gillor M, Neels H, Dietz H. Persistent levator co-activation is not associated with symptoms or bother of obstructed defecation. Int Urogynecol J. 2020, online ahead of print.","DOI":"10.1007\/s00192-020-04389-z"},{"key":"4734_CR19","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1002\/uog.20124","volume":"53","author":"R Cheung","year":"2019","unstructured":"Cheung R, Chan S, Shek K, Chung T, Dietz H. Pelvic organ prolapse in Caucasian and East Asian women: a comparative study. Ultrasound Obstet Gynecol. 2019;53:541\u20135.","journal-title":"Ultrasound Obstet Gynecol"},{"key":"4734_CR20","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1007\/s10151-013-0995-x","volume":"17","author":"HP Dietz","year":"2013","unstructured":"Dietz HP, Cartmill J. Imaging in patients with obstructed defecation. Tech Coloproctol. 2013;17:473\u20134.","journal-title":"Tech Coloproctol"}],"container-title":["International Urogynecology Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00192-021-04734-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00192-021-04734-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00192-021-04734-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,4]],"date-time":"2021-09-04T12:04:25Z","timestamp":1630757065000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00192-021-04734-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,26]]},"references-count":20,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2021,9]]}},"alternative-id":["4734"],"URL":"https:\/\/doi.org\/10.1007\/s00192-021-04734-w","relation":{},"ISSN":["0937-3462","1433-3023"],"issn-type":[{"value":"0937-3462","type":"print"},{"value":"1433-3023","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,26]]},"assertion":[{"value":"16 November 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 February 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 February 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"HP Dietz has received lecture honoraria and travel assistance from GE Medical and Mindray.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}}]}}