Evacuation proctography: a reappraisal of normal variability

Area of Science:

• Pelvic floor imaging and functional diagnostics.
• Gastroenterology and colorectal surgery.
• Radiology and medical imaging analysis.

Background:

• Accurate interpretation of evacuation proctography (EP) relies on established normative data.
• Previous studies on EP in asymptomatic individuals have faced methodological limitations.
• A need exists for comprehensive, gender-specific normative parameters for EP.

Purpose of the Study:

• To establish normative parameters for evacuation proctography (EP) in both male and female subjects.
• To provide a reliable dataset for the clinical interpretation of EP findings.
• To facilitate objective comparison of patient data against established norms.

Main Methods:

• Prospective performance of evacuation proctography (EP) on 46 healthy volunteers (28 female).
• Independent analysis of proctograms by two reviewers assessing anorectal dimensions, angle changes, evacuation time, contrast evacuated percentage, and rectal wall morphology.
• Objective assessment of established and novel defecatory structure and function variables.

Main Results:

• Normal ranges were determined for key EP variables, with significant gender differences noted primarily in rectal diameter.
• Mean end-evacuation times were 88s (males) and 128s (females); mean contrast evacuated was 71% (males) and 65% (females).
• Rectocoeles were prevalent in females (93%), and recto-rectal intussusception occurred in approximately 20% of subjects across both genders.

Conclusions:

• This study successfully defines normative ranges for anorectal dimensions and emptying parameters using EP.
• It characterizes the incidence and features of rectal wall abnormalities detected via EP.
• The established normative ranges are clinically applicable for disease comparison and diagnosis.