Defecographic evaluation of patients with defecation difficulties

Area of Science:

• Gastroenterology
• Pelvic Floor Imaging
• Functional Bowel Disorders

Background:

• Defecation difficulties, including straining and incomplete emptying, affect a significant patient population.
• Pelvic floor dysfunction is a common cause of these symptoms, often requiring detailed investigation.

Purpose of the Study:

• To evaluate defecographic findings in patients presenting with symptoms of straining, incomplete rectal emptying, and perineal descent.
• To compare the prevalence and types of defecographic abnormalities between female and male patients.

Main Methods:

• Defecographic studies were performed on 55 patients (36 females, 19 males) with specific defecation complaints.
• Key parameters analyzed included anorectal angles, anterior rectocele size, Ds-R (pelvic floor descent), internal rectal intussusception, and puborectalis sling activity.

Main Results:

• 91% of all patients exhibited abnormal defecographic findings, with higher prevalence in females.
• Common abnormalities included anterior rectoceles (91% in females), internal rectal intussusception (33% in females, 58% in males), and hypertonic puborectalis slings (25% in females, 68% in males).
• Patients with hypertonic puborectalis slings showed smaller straining angles; males with abnormal perineal descent had a greater Ds-R.

Conclusions:

• Defecography is highly effective in identifying pelvic floor abnormalities in patients with defecation dysfunction.
• Significant differences in the pattern and prevalence of abnormalities exist between genders, particularly concerning rectoceles and puborectalis sling hypertonicity.