Gastrointestinal transit scintigraphy in the evaluation of rectocele

Rectocele can cause chronic constipation and altered quality of life. In the presence of severe symptomatology and lack of response to conservative treatment, gastrointestinal motor function should be assessed. The aim of this study was to assess the utility of gastrointestinal transit scintigraphy in this pathology, analyzing its position in international guidelines.

We retrospectively evaluated twelve women with rectocele and chronic constipation, range of 31-74 years, referred for scintigraphic study as an assessment prior to prolapse treatment. Defecography was altered in 12 and anorectal manometry in 8. Following international guidelines, a dose of [¹¹¹In]In-DTPA (37 MBq) was administered together with standardized food to assess liquid gastric emptying and small-bowel and colonic transit. Areas of interest were defined in these locations to calculate the geometric center.

In 3 patients the radioisotopic study was normal, 3 showed a pattern of outlet obstruction, 3 colonic inertia, 2 slow small-bowel transit and 1 slow generalized transit. Thus, 50% of patients presented transit alterations not located in the rectosigmoid area.

Scintigraphy study provided useful information for the evaluation of patients with rectocele and constipation, influencing the diagnosis and therapeutic management. It proved to be a physiological method, providing both global and regional quantitative information. Like other authors, it is considered appropriate to use the study at the same level as the tests for the assessment of defecatory dynamics.