Fig. 3
Female patient aged 34 years with history of repeated four normal deliveries and complaining of chronic constipation. Defecography shows: (a): anterior rectocele about 4 cm (arrow). Evidence of rectal intussusception (arrow head). Lax pelvic floor. Anorectal angle (95°). 2D ultrasound shows: (b): anterior rectocele filled with gel measures about 2.5 cm and measures about 1.8 cm empty. Anorectal angle (102°). 3D ultrasound shows: at rest (c): levator area: transverse diameter 3.2 cm. AP diameter 4.6 cm. Hiatal area: 11.4 cm2. Thickness of internal sphincter 2.7 mm (Arrow). Thickness of external sphincter 3.4 mm (arrow head). Thickness of PRS about 3 mm (double arrows). During squeezing (d): levator area: transverse diameter 3.3 cm. AP diameter 3.9 cm. Hiatal area: 10.7 cm2. Thickness of internal sphincter 1.7 mm (arrow). Thickness of external sphincter 3 mm (arrow head). Thickness of PRS about 3.2 mm (double arrows). During straining (e): anterior rectocele measures about 2.8 cm. Wide levator area: transverse diameter 4 cm. AP diameter 6 cm. Hiatal area: 20.3 cm2. Attenuation of internal sphincter 1.7 mm (arrow). Attenuation of external sphincter 1.5 mm (arrow head). Attenuation of PRS about 2.9 mm (double arrows)