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Rectocele was diagnosed using translabial ultrasound, and obstructed defecation (OD) was diagnosed in accordance with the Roma IV diagnostic criteria. Both rectal and vaginal pressure were measured using peritron manometers at maximum Vasalva. To ensure stability, the test was performed three times with each patient.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 217 patients were enrolled in this study. True rectocele was diagnosed in 68 patients at a main rectal ampulla depth of 19\u00a0mm. Furthermore, 36 patients were diagnosed with OD. Symptomatic rectocele was significantly associated with older age (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01), a higher OD symptom score (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and a lower grade of apical prolapse (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). The rectal\u2013vaginal pressure gradient was higher in patients with symptomatic rectocele (37.4\u2009\u00b1\u200911.7\u00a0cm H<jats:sub>2<\/jats:sub>O) compared with patients with asymptomatic rectocele (16.9\u2009\u00b1\u20098.4\u00a0cm H<jats:sub>2<\/jats:sub>O,<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and patients without rectocele (17.1\u2009\u00b1\u20099.2\u00a0cm H<jats:sub>2<\/jats:sub>O,<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The rectal\u2013vaginal pressure gradient was found to be a risk factor for symptomatic rectocele in patients with POP. A rectal\u2013vaginal pressure gradient of &gt;\u200927.5\u00a0cm H<jats:sub>2<\/jats:sub>O was suggested as the cut-off point of the elevated pressure gradient.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12905-021-01304-6","type":"journal-article","created":{"date-parts":[[2021,4,20]],"date-time":"2021-04-20T11:09:37Z","timestamp":1618916977000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Rectal\u2013vaginal pressure gradient in patients with pelvic organ prolapse and symptomatic rectocele"],"prefix":"10.1186","volume":"21","author":[{"given":"Cheng","family":"Tan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Man","family":"Tan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Geng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Tang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,4,20]]},"reference":[{"key":"1304_CR1","doi-asserted-by":"crossref","unstructured":"Swift S. 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