{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,30]],"date-time":"2025-08-30T16:51:26Z","timestamp":1756572686553,"version":"3.37.3"},"reference-count":29,"publisher":"Korean Society of Coloproctology","issue":"4","license":[{"start":{"date-parts":[[2021,1,12]],"date-time":"2021-01-12T00:00:00Z","timestamp":1610409600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["coloproctol.org"],"crossmark-restriction":true},"short-container-title":["Ann Coloproctol"],"published-print":{"date-parts":[[2021,8,31]]},"abstract":"<jats:p>Purpose: External rectal prolapse (ERP) is frequently associated with other pelvic disorders, such as enterocele, rectocele, and perineal descent. Evacuation proctography makes it possible to visualize the development of such anatomical abnormalities. The aim of this study was to identify the variables that would predict associated abnormalities in patients with ERP.Methods: Between February 2010 and August 2019, 124 female patients with ERP, who were evaluated using proctography were included in this study. Enterocele was diagnosed when the extension of the loop of the small bowel was located between the vagina and rectum. A significant rectocele was defined as &gt;20 mm in diameter. Multivariate analysis was used to establish which morphological parameters best predicted the presence of enterocele or rectocele.Results: Sixty-five patients had ERP alone, while 59 patients (47.6%) had additional findings on proctography. The most frequently associated abnormality was enterocele with 48 of the patients (38.7%) having this condition. Rectocele was detected in 17 of the 124 patients (13.7%). The median length of the ERP was 30 mm (range, 7 to 147 mm). The results of the stepwise multiple regression analysis showed that a history of hysterectomy and the length of the ERP were significantly associated with the presence of enterocele. The analysis showed that the longer the prolapse, the higher the incidence of enterocele. A history of hysterectomy was also significantly associated with the presence of rectocele.Conclusion: Patients with ERP often have associated anatomical abnormalities and should be investigated thoroughly before planning surgical treatment.<\/jats:p>","DOI":"10.3393\/ac.2020.07.16","type":"journal-article","created":{"date-parts":[[2021,1,12]],"date-time":"2021-01-12T00:32:35Z","timestamp":1610411555000},"page":"218-224","update-policy":"https:\/\/doi.org\/10.3393\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Factors Predicting the Presence of Concomitant Enterocele and Rectocele in Female Patients With External Rectal Prolapse"],"prefix":"10.3393","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6211-0219","authenticated-orcid":true,"given":"Akira","family":"Tsunoda","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoko","family":"Takahashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenji","family":"Sato","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Kusanagi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1975","reference":[{"key":"ref1","first-page":"1133","volume-title":"Defecography: results of investigations in 2,816 patients","author":"Mellgren","year":"1994"},{"key":"ref2","first-page":"330","volume-title":"Procidentia of the rectum studied with cineradiography: a contribution to the discussion of causative mechanism","author":"Broden","year":"1968"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.184.2.1620863"},{"key":"ref4","first-page":"899","volume-title":"Defecography and proctography: results of 744 patients","author":"Agachan","year":"1996"},{"key":"ref5","first-page":"1525","volume-title":"Patient and surgeon ranking of the severity of symptoms associated with fecal incontinence: the fecal incontinence severity index","author":"Rockwood","year":"1999"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1007\/bf02056950"},{"key":"ref7","first-page":"S75","volume-title":"Enterocele: what is the clinical implication?","author":"Takahashi","year":"2006"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1136\/gut.30.12.1737"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-004-0526-y"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1007\/bf01889028"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2009.02024.x"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1007\/bf00290186"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.173.1.10397095"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-200010000-00022"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(81)90257-x"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2002.123819"},{"key":"ref17","first-page":"1717","volume-title":"Anatomic aspects of vaginal eversion after hysterectomy","author":"DeLancey","year":"1992"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-007-0219-4"},{"key":"ref19","first-page":"284","volume-title":"Enterocele: a review","author":"Holley","year":"1994"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-015-1395-1"},{"key":"ref21","first-page":"695","volume-title":"Four-contrast defecography: pelvic \u201cfloor-oscopy\u201d","author":"Altringer","year":"1995"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2007.01262.x"},{"key":"ref23","first-page":"239","volume-title":"Spontaneous rupture of the rectum with evisceration of small intestine through the anus: a case report","author":"Hultgren","year":"1986"},{"key":"ref24","first-page":"187","volume-title":"Rupture of the rectum with evisceration of small intestine through the anus: a complication of advanced rectal prolapse. 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