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Related Experiment Videos

Pelvic prolapse: assessment with evacuation proctography (defecography)

F M Kelvin1, D D Maglinte, J A Hornback

  • 1Department of Radiology, Methodist Hospital of Indiana, Indiana University School of Medicine, Indianapolis 46206.

Radiology
|August 1, 1992
PubMed
Summary

Evacuation proctography (EP) effectively diagnoses pelvic prolapse, identifying rectoceles, enteroceles, and sigmoidoceles. This imaging technique aids surgical planning by revealing unsuspected conditions and associated pelvic floor disorders.

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Area of Science:

  • Gastroenterology
  • Pelvic Floor Disorders
  • Diagnostic Imaging

Background:

  • Pelvic prolapse affects numerous women, impacting quality of life.
  • Accurate diagnosis is crucial for effective surgical planning.
  • Evacuation proctography (EP) is a specialized imaging technique.

Purpose of the Study:

  • To evaluate the diagnostic contribution of evacuation proctography (EP) in pelvic prolapse.
  • To assess the utility of EP in identifying rectoceles, enteroceles, and sigmoidoceles.
  • To determine the role of EP in preoperative surgical planning for pelvic floor disorders.

Main Methods:

  • A prospective study involving 74 consecutive patients undergoing EP.
  • Analysis of EP findings including rectocele, enterocele, sigmoidocele, and other pelvic floor abnormalities.

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  • Comparison of EP findings with physical examination where applicable.

    • Main Results:

    • Rectocele detected in 99% of patients; large rectoceles showed barium trapping without symptom correlation.
    • Enterocele identified in 18% and sigmoidocele in 5% of patients via EP, significantly more than by physical exam.
    • Additional findings like pelvic floor descent and anal incontinence noted in 65% of patients.

    Conclusions:

    • EP is valuable for preoperative evaluation of pelvic prolapse, especially with anorectal symptoms or enterocele risk.
    • EP aids surgical planning by detecting occult enteroceles, sigmoidoceles, and coexisting rectal evacuation disorders.
    • EP enhances the comprehensive assessment of complex pelvic floor dysfunction.