Rectal anatomy after rectopexy: cinedefecography versus MR-defecography

Area of Science:

• Pelvic floor disorders
• Diagnostic imaging techniques
• Gastroenterology

Background:

• Conventional defecography is used to diagnose evacuatory disorders.
• Dynamic MR imaging enables MR-defecography, an alternative without ionizing radiation.
• This study compares MR-defecography with conventional defecography post-rectopexy.

Purpose of the Study:

• To evaluate the correlation between MR-defecography and conventional defecography.
• To assess the diagnostic accuracy of MR-defecography after rectopexy for evacuatory disorders.

Main Methods:

• Twenty-one patients underwent sigmoidectomy and rectopexy for evacuatory disorders.
• Postoperative assessments included cineradiographic defecography and MR-defecography in 14 patients.
• Analysis focused on anorectal angle, pelvic floor position, and pelvic organ descent.

Main Results:

• MR-defecography and conventional defecography showed consistent results for anorectal angle and pelvic floor position during squeezing and evacuation.
• MR-defecography identified pelvic organ descent (bladder) in some patients.
• MR-defecography incorrectly indicated incomplete evacuation in 30% of patients with complete evacuation on cineradiography.

Conclusions:

• Both defecography methods yield comparable results for anorectal angle and perineal motility post-rectopexy.
• MR-defecography offers advantages in visualizing pelvic structures and enteroceles.
• Caution is advised regarding MR-defecography's accuracy in assessing evacuation completeness.