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Quantification of Levator Ani Hiatus Enlargement by Magnetic Resonance Imaging in Males and Females with Pelvic Organ Prolapse
Published on: April 17, 2019
Correlation between congenital pelvic floor muscle development assessed by magnetic resonance imaging and
Qionghe Liang1, Changgui Lu2, Peng Liu1
1Radiology department, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Nanjing, 210008, China.
Insights
Pelvic floor muscle development in children with congenital anorectal malformation (CAM) impacts bowel function after surgery. Perineal fistula showed a significant correlation between muscle development and improved defecation outcomes.
Area of Science:
- Pediatric Surgery
- Urology
- Radiology
Background:
- Congenital anorectal malformation (CAM) presents significant challenges in defecation for affected children.
- Postoperative bowel function is a critical determinant of long-term quality of life in these patients.
Purpose of the Study:
- To assess defecation in preschool-age children with CAM.
- To evaluate the correlation between pelvic floor muscle development, assessed via MRI, and postoperative bowel function.
Main Methods:
- Clinical data and MRI results from 89 male children with CAM were analyzed.
- Bowel function scores (BFS) were computed for patients with Perineal, Rectourethral, and Rectovesical fistulas.
- Pelvic floor muscle development (striated muscle complex - SMC) was assessed using MRI and correlated with BFS via the Cochran-Armitage Trend Test.
Main Results:
- Good SMC scores were observed in 77.4% of patients with Perineal fistula, correlating with BFS ≥ 17 in 77.4% of cases.
- Patients with Rectourethral and Rectovesical fistulas showed predominantly moderate to poor SMC scores, with limited instances of BFS ≥ 17.
- A significant correlation between SMC development and BFS was found in the Perineal fistula subgroup.
Conclusions:
- Pelvic floor muscle development is significantly correlated with improved postoperative defecation in children with Perineal fistula.
- Further research may be needed to optimize outcomes for Rectourethral and Rectovesical fistula subtypes.
Objective:
Children with congenital anorectal malformation (CAM) experience challenges with defecation. This study aims to assess defecation in preschool-age children with CAM and to evaluate the correlation between pelvic floor muscle developed assessed by magnetic resonance imaging (MRI) and postoperative defecation.
Methods:
We collected clinical data and MRI results from 89 male children with CAM. The bowel function scores for children with Perineal (cutaneous) fistula, Rectourethral fistula(Prostatic or Bulbar), and Rectovesical fistula were computed. MRI scans were subjected to image analysis of the striated muscle complex (SMC). The association between pelvic floor muscle score and bowel function score was examined using the Cochran-Armitage Trend Test.
Results:
We observed that 77.4% of the SMC scores by MRI for Perineal fistula were good. The Rectourethral fistula SMC score was 40.6% for moderate and 59.4% for poor. The SMC score for Rectovesical fistula was 100% for moderate. Furthermore, 77.4% of patients with Perineal fistula had bowel function scores (BFS) ≥ 17 points. Among those with Rectourethral fistula and Rectovesical fistula, 12.5% and 0 had BFS ≥ 17 points, respectively. An analysis of muscle development and bowel function in patients with Rectovesical fistula, Rectourethral fistula, and Perineal fistula revealed a correlation between SMC development and BFS. Subgroup analysis showed that the Perineal fistula had statistical significance; however, the Rectourethral fistula and Rectovesical fistula were not statistically significant.
Conclusion:
A correlation exists between pelvic floor muscle development and postoperative defecation in children with Perineal fistula.
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