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Lukies M, Harisis G, Jarema A, Scicchitano M, MacLaurin W. Defecating proctography: A pictorial essay. Radiography (Lond) 2022; 28:628-633. [PMID: 35569315 DOI: 10.1016/j.radi.2022.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 04/11/2022] [Accepted: 04/23/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To provide an illustrative description of the technique and spectrum of findings in defecating proctography. KEY FINDINGS Important findings on defecating proctography include rectocoele, enterocoele, sigmoidocoele, cystocoele, intussusception, rectal prolapse, descending perineum, incomplete emptying, anismus, and faecal incontinence. This review article illustrates these key findings with examples. CONCLUSION Defecating proctography is a well-established and cost-effective method of assessing disordered defecation. In conjunction with clinical information and other diagnostic tests, findings on defecating proctography can guide appropriate multidisciplinary management and may lead to improvement in embarrassing and debilitating symptoms in many patients. IMPLICATIONS FOR PRACTICE This review article provides a suggested technique and covers the spectrum of findings on defecating proctography.
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Affiliation(s)
- M Lukies
- Department of Radiology, Alfred Health, Melbourne, VIC, Australia.
| | - G Harisis
- Department of Radiology, Alfred Health, Melbourne, VIC, Australia
| | - A Jarema
- Department of Radiology, Alfred Health, Melbourne, VIC, Australia
| | - M Scicchitano
- Department of Radiology, Alfred Health, Melbourne, VIC, Australia
| | - W MacLaurin
- Department of Radiology, Alfred Health, Melbourne, VIC, Australia
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Biomechanical integrity score of the female pelvic floor. Int Urogynecol J 2022; 33:1617-1631. [PMID: 35230483 PMCID: PMC9206610 DOI: 10.1007/s00192-022-05120-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 02/03/2022] [Indexed: 11/03/2022]
Abstract
INTRODUCTION AND HYPOTHESIS The aim of this study is to develop and validate a new integral parameter, the Biomechanical Integrity score (BI-score), for the characterization of the female pelvic floor. METHODS A total of 253 subjects with normal and pelvic organ prolapse (POP) conditions were included in the multi-site observational, case-control study; 125 subjects had normal pelvic floor conditions, and 128 subjects had POP stage II or higher. A Vaginal Tactile Imager (VTI) was used to acquire and automatically calculate 52 biomechanical parameters for eight VTI test procedures (probe insertion, elevation, rotation, Valsalva maneuver, voluntary muscle contractions in two planes, relaxation, and reflex contraction). Statistical methods were applied (t-test, correlation) to identify the VTI parameters sensitive to the pelvic conditions. RESULTS Twenty-six parameters were identified as statistically sensitive to POP development. They were subdivided into five groups to characterize (1) tissue elasticity, (2) pelvic support, (3) pelvic muscle contraction, (4) involuntary muscle relaxation, and (5) pelvic muscle mobility. Every parameter was transformed to its standard deviation units against the patient age similar to T-score for bone density. Linear combinations with specified weights led to the composition of five component parameters for groups (1)-(5) and the BI-score in standard deviation units. The p-value for the BI-score has p = 4.3 × 10-31 for POP versus normal conditions. A reference BI-score curve against age for normal pelvic floor conditions was defined. CONCLUSIONS Quantitative transformations of the pelvic tissues, support structures, and functions under diseased conditions may be studied with the BI-score in future research and practical applications.
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Diagnostik der Beckenbodeninsuffizienz. COLOPROCTOLOGY 2021. [DOI: 10.1007/s00053-021-00551-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ghahremani GG, Mittal RK. Pulsion diverticula of the rectum: Radiological diagnosis and clinical implications. J Med Imaging Radiat Oncol 2021; 65:286-292. [PMID: 33606362 DOI: 10.1111/1754-9485.13154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/12/2021] [Accepted: 01/21/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The aim of this study was to investigate the appearance of acquired rectal diverticula on barium enema and computed tomography (CT) and to review the pertinent clinical data about this entity. METHODS This series included 3 men and 6 women, who ranged in age from 47 to 82 years (average: 64 years). Air-contrast barium enema in 6 patients with history of anorectal disease or obstructed defecation demonstrated rectal diverticula. In these cases, multiple radiographs of the rectosigmoid region were obtained in upright position while the patient was relaxing or straining without any attempt to evacuate the barium. In 3 cases, the lateral rectal diverticula were incidental finding on CT studies that were performed for various unrelated abdominal complaints. RESULTS Pulsion type of diverticulum presenting as a wide-neck outpouching was detected on the lateral rectal wall in 5 and on the posterior wall in 4 patients. They measured 2-3 cm in diameter when filled with contrast material or gas, and became even larger when the intraluminal pressure was increased by straining. CONCLUSION Pulsion diverticula of the rectum present as a wide-neck outpouching of the lateral or posterior rectal wall in adult patients. This acquired abnormality is usually associated with coexisting anorectal lesions or defecation disorders. The practising radiologists and colorectal surgeons should be aware of this uncommon condition, its appearance on barium enema and other imaging studies, and its clinical implications.
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Affiliation(s)
- Gary G Ghahremani
- Department of Radiology, University of California-San Diego Medical Center, San Diego, California, USA
| | - Ravinder K Mittal
- Department of Internal Medicine, Division of Gastroenterology, University of California-San Diego Medical Center, San Diego, California, USA
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3D-Volume Rendering of the Pelvis with Emphasis on Paraurethral Structures Based on MRI Scans and Comparisons between 3D Slicer and OsiriX®. J Med Syst 2021; 45:27. [PMID: 33469726 PMCID: PMC7815623 DOI: 10.1007/s10916-020-01695-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 11/24/2020] [Indexed: 10/27/2022]
Abstract
The feasibility of rendering three dimensional (3D) pelvic models of vaginal, urethral and paraurethral lesions from 2D MRI has been demonstrated previously. To quantitatively compare 3D models using two different image processing applications: 3D Slicer and OsiriX. Secondary analysis and processing of five MRI scan based image sets from female patients aged 29-43 years old with vaginal or paraurethral lesions. Cross sectional image sets were used to create 3D models of the pelvic structures with 3D Slicer and OsiriX image processing applications. The linear dimensions of the models created using the two different methods were compared using Bland-Altman plots. The comparisons demonstrated good agreement between measurements from the two applications. The two data sets obtained from different image processing methods demonstrated good agreement. Both 3D Slicer and OsiriX can be used interchangeably and produce almost similar results. The clinical role of this investigation modality remains to be further evaluated.
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Langenbach MC, Park C, Vogl TJ, Beeres M, Scholtz JE, Gruber-Rouh T. The use of dynamic MR imaging in patients with clinical pelvic floor disorders. Clin Physiol Funct Imaging 2020; 41:173-180. [PMID: 33210817 DOI: 10.1111/cpf.12681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 06/23/2020] [Accepted: 11/16/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To determine the differences and challenging aspects of dynamic magnetic resonance defecography (MRD) compared to conventional defecography (CD) in diagnostic of clinical symptomatic pelvic floor dysfunction. METHODS Fifty patients (44 females, 6 males; mean age: 57 years) with symptomatic pelvic floor dysfunction underwent both examinations, CD and MRD. Results were retrospectively intra-individual and interindividual evaluated in this multicentre study. Visibility and accuracy in diagnosis and classification of rectal prolapse, rectocele, enterocele, sigma diverticula and Cul-de-sac phenomenon/syndrome were observed. Differences were analysed using Mann-Whitney U test. P-values < 0.05 were considered as statistically significant. RESULTS CD was significantly superior to MRD in diagnosis and grading of rectal prolapse (p < .001), diagnosis and metric measurements of rectoceles (p = .016), diagnosis of elongated sigmoid colon (p = .008) and Cul-de-sac phenomenon and syndrome, respectively (p = .015; p = .008). MRD revealed equal results to CD in detection, localization, tendency to retention and enlargement of rectoceles (p = .337) and findings of enteroceles (p = .604) as well as sigma diverticula (p = .149). CONCLUSIONS The complementary use of both examination methods, CD and MRD, is important to achieve a comprehensive look on every aspect of pelvic floor disorders and gain optimal results in detection and evaluation of all major disorders of the pelvic floor.
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Affiliation(s)
- Marcel C Langenbach
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany
| | - Clara Park
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany
| | - Thomas J Vogl
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany
| | - Martin Beeres
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany
| | - Jan-Erik Scholtz
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany
| | - Tatjana Gruber-Rouh
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt, Germany
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Jeong HY, Yang SJ, Cho DH, Park DH, Lee JK. Comparison of 3-Dimensional Pelvic Floor Ultrasonography and Defecography for Assessment of Posterior Pelvic Floor Disorders. Ann Coloproctol 2020; 36:256-263. [PMID: 32178497 PMCID: PMC7508475 DOI: 10.3393/ac.2020.02.09] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 02/09/2020] [Indexed: 12/18/2022] Open
Abstract
PURPOSE The aim of this study was to determine the accuracy of 3-dimensional (3D) pelvic floor ultrasonography and compare it with defecography in assessment of posterior pelvic disorders. METHODS Eligible patients were consecutive women undergoing 3D pelvic floor ultrasonography at one hospital between August 2017 and February 2019. All 3D pelvic floor ultrasonography was performed by one examiner. A total of 167 patients with suspected posterior pelvic disorder was retrospectively enrolled in the study. The patients were divided into 3 groups according to the main symptoms. RESULTS There were 82 rectoceles on defecography (55 barium trapping) and 84 on 3D pelvic floor ultrasonography. Each modality identified 6 enteroceles. There were 43 patients with pelvic floor dyssynergia on defecography and 41 on ultrasonography. There were 84 patients with intussusception on defecography and 41 on 3D pelvic floor ultrasonography. Agreement of the 2 diagnostic tests was confirmed using Cohen's kappa value. Rectocele (kappa, 0.784) and enterocele (kappa, 0.654) both indicated good agreement between defecography and 3D pelvic floor ultrasonography. In addition, pelvic floor dyssynergia (kappa, 0.406) showed moderate agreement, while internal intussusception (kappa, 0.296) had fair agreement. CONCLUSION This study showed good agreement for detection of posterior pelvic disorders between defecography and 3D pelvic floor ultrasonography.
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Affiliation(s)
| | - Shi-Jun Yang
- Department of Surgery, Seoul Song Do Hospital, Seoul, Korea
| | - Dong Ho Cho
- Department of Surgery, Seoul Song Do Hospital, Seoul, Korea
| | - Duk Hoon Park
- Department of Surgery, Seoul Song Do Hospital, Seoul, Korea
| | - Jong Kyun Lee
- Department of Surgery, Seoul Song Do Hospital, Seoul, Korea
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Pelvic floor dysfunctions: how to image patients? Jpn J Radiol 2019; 38:47-63. [DOI: 10.1007/s11604-019-00903-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Accepted: 11/21/2019] [Indexed: 12/13/2022]
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Kim NY, Kim DH, Pickhardt PJ, Carchman EH, Wald A, Robbins JB. Defecography: An Overview of Technique, Interpretation, and Impact on Patient Care. Gastroenterol Clin North Am 2018; 47:553-568. [PMID: 30115437 DOI: 10.1016/j.gtc.2018.04.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Pelvic floor and defecatory dysfunction are common in the female patient population. When combined with physical examination, barium defecography allows for accurate and expanded assessment of the underlying pathology and helps to guide future intervention. Understanding the imaging findings of barium defecography in the spectrum of pathology of the anorectum and pelvic floor allows one to appropriately triage and treat patients presenting with defecatory dysfunction.
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Affiliation(s)
- Nathan Y Kim
- Department of Radiology, University of Wisconsin School of Medicine & Public Health, 600 Highland Avenue, Madison, WI 53792, USA
| | - David H Kim
- Department of Radiology, University of Wisconsin School of Medicine & Public Health, 600 Highland Avenue, Madison, WI 53792, USA
| | - Perry J Pickhardt
- Department of Radiology, University of Wisconsin School of Medicine & Public Health, 600 Highland Avenue, Madison, WI 53792, USA
| | - Evie H Carchman
- Department of Surgery, University of Wisconsin School of Medicine & Public Health, 600 Highland Avenue, Madison, WI 53792, USA
| | - Arnold Wald
- Department of Medicine, University of Wisconsin School of Medicine & Public Health, 600 Highland Avenue, Madison, WI 53792, USA
| | - Jessica B Robbins
- Department of Radiology, University of Wisconsin School of Medicine & Public Health, 600 Highland Avenue, Madison, WI 53792, USA.
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Zafar A, Seretis C, Feretis M, Karandikar S, Williams SC, Goldstein M, Chapman M. Comparative study of magnetic resonance defaecography and evacuation proctography in the evaluation of obstructed defaecation. Colorectal Dis 2017; 19:O204-O209. [PMID: 28304122 DOI: 10.1111/codi.13657] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Accepted: 02/13/2017] [Indexed: 12/13/2022]
Abstract
AIM Obstructed defaecation syndrome is a common condition of multifactorial aetiology and requires specialized evaluation. Accurate and reproducible pelvic floor imaging is imperative for multidisciplinary decision-making. Evacuation proctography (EP) and magnetic resonance defaecography (MRD) are the main imaging modalities used to assess dynamic pelvic floor function. The aim of this prospective study was to compare the findings and acceptability of MRD and EP in the same cohort of patients. METHOD This was a prospective comparative study of MRD vs EP in 55 patients with obstructed defaecation syndrome in a single National Health Service Foundation Trust. RESULTS Fifty-five patients were recruited and underwent both EP and MRD. Detection rates for rectocoele were similar (82% vs 73%, P = 0.227), but EP revealed a significantly higher number of trapping rectocoeles compared to MRD (75% vs 31%, P < 0.001). EP detected more rectal intussusceptions than MRD (56% vs 35%, P = 0.023). MRD appeared to underestimate the size of the identified rectocoele, although it detected a significant number of anatomical abnormalities in the middle and anterior pelvic compartment not seen on EP (1.8% enterocoele, 9% peritoneocoele and 20% cystocoele). Patients achieved higher rates of expulsion of rectal contrast during EP compared to MRD, but this difference was not significant (76% vs 64% in MRD, P = 0.092). Of the two studies, patients preferred MRD. CONCLUSIONS MRD provides a global assessment of pelvic floor function and anatomical abnormality. MRD is better tolerated by patients but it is not as sensitive as EP in detecting trapping rectocoeles and intussusceptions.
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Affiliation(s)
- A Zafar
- Department of General and Colorectal Surgery, Heart of England NHS Trust, Birmingham, UK
| | - C Seretis
- Department of General and Colorectal Surgery, Heart of England NHS Trust, Birmingham, UK
| | - M Feretis
- Department of General and Colorectal Surgery, Heart of England NHS Trust, Birmingham, UK
| | - S Karandikar
- Department of General and Colorectal Surgery, Heart of England NHS Trust, Birmingham, UK
| | - S C Williams
- Department of Radiology, Heart of England NHS Trust, Birmingham, UK
| | - M Goldstein
- Department of Radiology, Heart of England NHS Trust, Birmingham, UK
| | - M Chapman
- Department of General and Colorectal Surgery, Heart of England NHS Trust, Birmingham, UK
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Abstract
Pelvic floor dysfunction and fecal incontinence is a common and debilitating condition in women, particularly as women age, and often goes under-reported to health care providers. It is important for providers to ask patients about possible symptoms. An algorithm for evaluation and treatment is presented. Current and future therapies are described and discussed.
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Iacobellis F, Brillantino A, Renzi A, Monaco L, Serra N, Feragalli B, Iacomino A, Brunese L, Cappabianca S. MR Imaging in Diagnosis of Pelvic Floor Descent: Supine versus Sitting Position. Gastroenterol Res Pract 2016; 2016:6594152. [PMID: 26880893 PMCID: PMC4737448 DOI: 10.1155/2016/6594152] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 08/13/2015] [Indexed: 12/31/2022] Open
Abstract
Introduction. Functional disorders of the pelvic floor represent have a significant impact on the quality of life. The advent of open-configuration systems allowed for the evaluation of defecation with MR imaging in sitting position. The purpose of the present study is to compare the results of static and dynamic pelvic MR performed in supine position versus sitting position, using a new MR prototype machine, in the diagnosis of pelvic floor descent. Materials and Methods. Thirty-one patients with pelvic floor disorders were enrolled, and underwent MR Defecography in supine position with 1.5 T closed magnet (MAGNETOM Symphony, Siemens, Germany) and in sitting position with a 0.25-Tesla open magnet system (G-Scan ESAOTE, Italy). Results. In rest and squeezing phases, positions of bladder, vagina, and ARJ were significantly different when the patient was imaged in supine versus sitting position. In the defecation phase, a significant difference for the bladder and vagina position was detected between the two exams whereas a significant difference for the ARJ was not found. A statistically significant difference exists when the pelvic floor descent is evaluated in sitting versus supine position. Conclusion. Our results show that MR Defecography in sitting position may represent a useful tool to correctly diagnose and grade the pelvic organ descent.
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Affiliation(s)
- Francesca Iacobellis
- Department of Radiology, Second University of Naples, Piazza Miraglia 2, 80138 Napoli, Italy
| | - Antonio Brillantino
- “Villa delle Querce” Hospital, Via Battistello Caracciolo 48, 80136 Napoli, Italy
| | - Adolfo Renzi
- “Villa delle Querce” Hospital, Via Battistello Caracciolo 48, 80136 Napoli, Italy
| | - Luigi Monaco
- “Villa Esther” Hospital, Via Due Principati 169, 83100 Avellino, Italy
| | - Nicola Serra
- Department of Radiology, Second University of Naples, Piazza Miraglia 2, 80138 Napoli, Italy
| | - Beatrice Feragalli
- Department of Medical, Oral and Biotechnological Sciences, “G. D'Annunzio” University, Via dei Vestini, 66013 Chieti, Italy
| | - Aniello Iacomino
- Department of Radiology, Second University of Naples, Piazza Miraglia 2, 80138 Napoli, Italy
| | - Luca Brunese
- Department of Health Science, University of Molise, Viale Giovanni Paolo II 1, 86100 Campobasso, Italy
| | - Salvatore Cappabianca
- Department of Radiology, Second University of Naples, Piazza Miraglia 2, 80138 Napoli, Italy
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A review of functional pelvic floor imaging modalities and their effectiveness. Clin Imaging 2015; 39:559-65. [DOI: 10.1016/j.clinimag.2015.02.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 02/06/2015] [Accepted: 02/23/2015] [Indexed: 02/06/2023]
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Berghmans B, Nieman F, Leue C, Weemhoff M, Breukink S, van Koeveringe G. Prevalence and triage of first-contact complaints on pelvic floor dysfunctions in female patients at a Pelvic Care Centre. Neurourol Urodyn 2015; 35:503-8. [DOI: 10.1002/nau.22739] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 01/08/2015] [Indexed: 12/17/2022]
Affiliation(s)
- Bary Berghmans
- Pelvic Care Centre Maastricht; Maastricht University Medical Centre; Maastricht The Netherlands
| | - Fred Nieman
- Department of Clinical Epidemiology & Medical Technology Assessment; Maastricht University Medical Centre; Maastricht The Netherlands
| | - C. Leue
- Pelvic Care Centre Maastricht; Maastricht University Medical Centre; Maastricht The Netherlands
| | - M. Weemhoff
- Pelvic Care Centre Maastricht; Maastricht University Medical Centre; Maastricht The Netherlands
| | - S. Breukink
- Pelvic Care Centre Maastricht; Maastricht University Medical Centre; Maastricht The Netherlands
| | - G. van Koeveringe
- Pelvic Care Centre Maastricht; Maastricht University Medical Centre; Maastricht The Netherlands
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Melchior C, Bridoux V, Touchais O, Savoye-Collet C, Leroi AM. MRI defaecography in patients with faecal incontinence. Colorectal Dis 2015; 17:O62-9. [PMID: 25641440 DOI: 10.1111/codi.12889] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 10/09/2014] [Indexed: 12/13/2022]
Abstract
AIM Faecal incontinence (FI) requires careful assessment of its aetiology to determine the most effective treatment. The aims of this study were to evaluate MRI defaecography in FI and to compare it with clinical examination combined with rigid rectoscopy in assessing the pelvic floor in patients with FI. METHOD Consecutive patients with FI referred over a 3-year period to our tertiary centre for MRI defaecography were retrospectively studied. MRI images of the pelvic floor were compared with clinical examination and anuscopy and rectoscopy. RESULTS Seventy-four female patients [mean age 60.5 (30.0-81.0) years] were recruited. MRI defaecography showed conditions which often overlapped, including internal intussusception in 19 (25.7%) and pelvic floor descent in 24 (32.4%). There was average agreement between MRI and clinical examination for a significant anterior rectocoele (κ = 0.40) and poor agreement between MRI and anuscopy/rectoscopy for intra-rectal (κ = 0.06) and intra-anal intussusception (κ = 0.11). CONCLUSION Other than for anterior rectocoele, there is poor correlation between MRI defaecography and clinical examination with rigid rectoscopy. MRI can detect a variety of abnormal static and dynamic pelvic disorders. This includes enterocoele, which could result in a modification of the surgical approach to intussusception and anterior rectocoele.
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Affiliation(s)
- C Melchior
- INSERM U1073, Service de Physiologie Digestive, Hôpital Charles Nicolle, Rouen, France
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Berghmans B, Nieman F, Leue C, Weemhoff M, Breukink S, van Koeveringe G. Prevalence and triage of first contact pelvic floor dysfunction complaints in male patients referred to a Pelvic Care Centre. Neurourol Urodyn 2015; 35:487-91. [DOI: 10.1002/nau.22733] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 12/15/2014] [Indexed: 12/17/2022]
Affiliation(s)
- Bary Berghmans
- Pelvic Care Centre Maastricht; Maastricht University Medical Centre; Maastricht The Netherlands
| | - Fred Nieman
- Department of Clinical Epidemiology & Medical Technology Assessment; Maastricht University Medical Centre; Maastricht The Netherlands
| | - C. Leue
- Pelvic Care Centre Maastricht; Maastricht University Medical Centre; Maastricht The Netherlands
| | - M. Weemhoff
- Pelvic Care Centre Maastricht; Maastricht University Medical Centre; Maastricht The Netherlands
| | - S. Breukink
- Pelvic Care Centre Maastricht; Maastricht University Medical Centre; Maastricht The Netherlands
| | - G. van Koeveringe
- Pelvic Care Centre Maastricht; Maastricht University Medical Centre; Maastricht The Netherlands
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