Differential diagnosis of posterior compartment prolapse using transperineal ultrasound

Abstract

Pelvic organ prolapse (POP) of the posterior compartment encompasses various conditions that may have similar clinical presentation, including obstructed defecation and presence of a bulge in the vagina. Management of posterior compartment POP requires accurate diagnosis of the underlying pathology to provide the correct treatment. Currently, transperineal ultrasound is used to diagnose significant descent of the posterior compartment defined as downward displacement of the rectal ampulla ≥ 15 mm below the pubic symphysis1. In addition to detecting posterior compartment POP, ultrasound may also allow differentiation between pathologies that affect the posterior compartment, including rectocele, combined rectoenterocele, enterocele and rectal intussusception2. Here we illustrate the differential diagnoses of posterior compartment POP based exclusively on transperineal ultrasound imaging.