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Related Experiment Video

Updated: Aug 16, 2025

Quantification of Levator Ani Hiatus Enlargement by Magnetic Resonance Imaging in Males and Females with Pelvic Organ Prolapse
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Three-dimensional high-resolution anorectal manometry: A comparative pilot study with X-ray defaecography.

Qihong Liu1,2,3, Wenyi Fang1,2,3, Peilin Zhao1,2,3

  • 1The Second People's Hospital Affiliated to Fujian University of Chinese Medicine, Fuzhou, China.

Medicine
|December 23, 2022
PubMed
Summary

Three-dimensional high-resolution anorectal manometry (3DHRAM) reliably diagnoses paradoxical puborectalis syndrome (PPS). This new technique offers comparable accuracy to X-ray defecography for pelvic floor disorder diagnosis.

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Area of Science:

  • Gastroenterology and Pelvic Floor Disorders

Background:

  • Pelvic floor disorders, including paradoxical puborectalis syndrome (PPS), present diagnostic challenges.
  • X-ray defaecography is the current gold standard for diagnosing PPS.

Purpose of the Study:

  • To evaluate the diagnostic reliability of three-dimensional high-resolution anorectal manometry (3DHRAM) for paradoxical puborectalis syndrome (PPS).
  • To compare 3DHRAM's diagnostic performance against X-ray defaecography.

Main Methods:

  • Prospective study comparing 3DHRAM and X-ray defaecography in patients with dyschezia.
  • Calculation of sensitivity, specificity, positive and negative predictive values for 3DHRAM criteria.
  • Development of a diagnostic strategy for PPS using 3DHRAM data.

Main Results:

  • 3DHRAM demonstrated a kappa value of 0.706 when compared to X-ray defaecography.
  • High diagnostic accuracy for 3DHRAM: sensitivity 95.83%, specificity 80.43%, positive predictive value 71.88%, and AUC 0.922.
  • Twenty-three patients were diagnosed with PPS via X-ray defaecography.

Conclusions:

  • 3DHRAM is a reliable tool for diagnosing paradoxical puborectalis syndrome (PPS).
  • 3DHRAM shows comparable diagnostic reliability to X-ray defaecography for pelvic floor disorders.
  • Further research is needed to fully classify the anatomical data provided by 3DHRAM.