Puborectalis Syndrome as a Phenotype of Dyssynergic Defecation in Chronic Constipation: a Comparative Study of Defecography,High-resolution Anorectal Manometry, and Pelvic Floor Ultrasound

June 28, 2026 updated by: Weidong Tong, Third Military Medical University
Patients with suspected DD who met the Rome IV criteria were divided into the DD group and other types of constipation groups. The differences between the two groups were analyzed to explore the precise diagnostic scheme for DD.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

This study was conducted solely at the Army Specialized Medical Center and was a single-center, bidirectional cohort study. Patients with suspected dyssynergic defecation who visited the constipation specialty clinic of Daping Hospital were collected. After the patients signed the informed consent form, they were asked to fill out the questionnaire (general clinical data questionnaire, Wexner constipation rating scale, ODS rating scale, and constipation patient quality of life scale (PAC-QOL)). The baseline data of the patients (such as age, gender, symptoms, constipation scale scores, intestinal satisfaction scores, etc.) and the results of anorectal manometry, defecography, and perineal ultrasound were statistically analyzed. Patients meeting the Rome IV criteria were grouped through DFG, ARM, and pelvic floor ultrasound examination. The differences in clinical main symptoms, constipation scores, defecography, perineal ultrasound, etc. between the two groups were observed, and the roles and correlations of each parameter in diagnosis were analyzed.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Observational

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
164

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • China
    • Chongqing Municipality
      • Yuzhong, Chongqing Municipality, China, 400042
        • Army Medical Center (Daping Hospital)

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Probability Sample

Study Population

patients with suspected PRS-related DD

Description

Inclusion Criteria:

  1. Age ranges from 16 to 85 years old.
  2. Constipation patients should meet the Rome Ⅳ criteria for chronic constipation (must include two or more of the following: ① At least 25% of bowel movements are strenuous; ② At least 25% of bowel movements are lumpy or hard stools; ③ At least 25% of bowel movements are accompanied by a sense of incomplete evacuation; ④ At least 25% of bowel movements are associated with a feeling of anorectal obstruction or blockage; ⑤ At least 25% of bowel movements require manual assistance; ⑥ Fewer than 3 bowel movements per week). The healthy volunteer group has no above - mentioned constipation symptoms.
  3. Participants should be able to understand and complete relevant questionnaires.
  4. Participants should be willing to follow the research protocol and sign the informed consent form.

Exclusion Criteria:

  1. Pregnant women and lactating women
  2. Suffering from gastrointestinal and other malignant tumors
  3. Suffering from diseases such as diabetes and Parkinson's disease
  4. Currently participating in other clinical trials

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort

Group / Cohort

A group or subgroup of participants in an observational study that is assessed for biomedical or health outcomes.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
patients with suspected PRS-related DD
Other: Analysis of inter-group differences
Analysis of inter-group differences

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Rectal emptying rate，（%）
Time Frame: Baseline assessment
Rectal emptying rate is defined as the reduction in rectal area from pre-evacuation to post-evacuation, expressed as a percentage of the pre-evacuation area, as assessed by defecography.
Baseline assessment

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Obstructed Defecation Syndrome score，（ODS score）
Time Frame: Baseline assessment
the minimum value is 0,and maximum value is 31; a higher scores mean a worse outcome.
Baseline assessment
Cleveland Clinic Constipation Score,(CCCS)
Time Frame: Baseline assessment
the minimum value is 0,and maximum value is 30; a higher scores mean a worse outcome.
Baseline assessment
Patient Assessment of Constipation Quality of Life total score，（PAC-QOL score）
Time Frame: Baseline assessment
the minimum value is 0,and maximum value is 112; a higher scores mean a worse outcome.
Baseline assessment
Self-Rating Anxiety Scale score，（SAS score）
Time Frame: Baseline assessment
the minimum value is 25,and maximum value is 100; a higher scores mean a worse outcome.
Baseline assessment
Bristol Stool Form Scale score
Time Frame: Baseline assessment
the minimum value is 1,and maximum value is 7; a higher scores mean a worse outcome.
Baseline assessment
Body Mass Index
Time Frame: Baseline assessment
Baseline assessment
Disease duration,(year)
Time Frame: Baseline assessment
Baseline assessment
ARA change on DFG，(°)
Time Frame: Baseline assessment
changes in anorectal angle during defecography
Baseline assessment
Anal canal diameter on DFG，（mm）
Time Frame: Baseline assessment
anal canal diameter during straining on DFG
Baseline assessment
PRS on DFG
Time Frame: Baseline assessment
Puborectalis syndrome indicated by the defecography diagnostic report.
Baseline assessment
IRP on DFG
Time Frame: Baseline assessment
Internal rectal prolapse indicated by the defecography diagnostic report.
Baseline assessment
Rectocele on DFG
Time Frame: Baseline assessment
Rectocele indicated by the defecography diagnostic report.
Baseline assessment
Anal Resting Pressure，（mmHg）
Time Frame: Baseline assessment
Anal Resting Pressure measured by High-resolution Anorectal Manometry
Baseline assessment
Anal Squeeze Pressure,(mmHg)
Time Frame: Baseline assessment
Anal Squeeze Pressure measured by High-resolution Anorectal Manometry
Baseline assessment
Rectal propulsive pressure,(mmHg)
Time Frame: Baseline assessment
Rectal propulsive pressure measured by High-resolution Anorectal Manometry
Baseline assessment
Anal relaxation rate,(%)
Time Frame: Baseline assessment
Anal relaxation rate measured by High-resolution Anorectal Manometry during defecation
Baseline assessment
DD on HR-ARM
Time Frame: Baseline assessment
Dyssynergic defecation(DD) reported by high-resolution anorectal manometry parameters, with diagnostic criteria of rectal pressure during straining >45mmHg and anal canal relaxation rate <20%.
Baseline assessment
ARA change on TPUS,(°)
Time Frame: Baseline assessment
changes in anorectal angle during evacuation measured by Transperineal Ultrasound
Baseline assessment
Right PRM thickness change on TPUS,(mm)
Time Frame: Baseline assessment
Changes in right puborectalis muscle thickness during defecation measured by Transperineal Ultrasound
Baseline assessment
Left PRM thickness change on TPUS,(mm)
Time Frame: Baseline assessment
Changes in left puborectalis muscle thickness during defecation measured by Transperineal Ultrasound
Baseline assessment
PRS on TPUS
Time Frame: Baseline assessment
Puborectalis syndrome(PRS) indicated by the transperineal ultrasound diagnostic report
Baseline assessment

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Third Military Medical University

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Study Director: Weidong Tong, MD, Army Medical Center (Daping Hospital)

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
July 21, 2023

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
May 31, 2026

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
May 31, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
June 16, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
June 28, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
July 6, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
July 6, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
June 28, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
July 1, 2023

More Information

Terms related to this study

Keywords

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • PRS202409

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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