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Simultaneous dynamic proctography and peritoneography for pelvic floor disorders

S M Sentovich¹, L J Rivela, A G Thorson

¹Department of Surgery, New England Deaconess Hospital, Boston, Massachusetts, USA.

Diseases of the Colon and Rectum

|September 1, 1995

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A new diagnostic technique, simultaneous dynamic proctography and peritoneography, effectively identifies rectal and pelvic floor disorders. This method aids in better treatment planning for patients experiencing obstructed defecation and pelvic prolapse.

Area of Science:

Gastroenterology
Pelvic Floor Disorders
Diagnostic Imaging

Background:

Obstructed defecation and pelvic prolapse significantly impact quality of life.
Accurate diagnosis of rectal and pelvic floor pathology is crucial for effective treatment.

Purpose of the Study:

To evaluate a novel diagnostic technique for identifying rectal and pelvic floor pathology.
To assess the utility of this technique in patients with obstructed defecation, pelvic fullness/prolapse, or chronic pelvic pain.

Main Methods:

Thirteen women with symptomatic pelvic floor disorders and nondiagnostic examinations were studied.
Simultaneous dynamic proctography (DPG) and peritoneography were performed using contrast material.
Pelvic X-rays and fluoroscopic videotaping of defecation were utilized.

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Main Results:

The technique identified enteroceles in 10 of 13 patients, including previously unsuspected cases.
It confirmed rectoceles and rectal prolapse identified on physical examination.
Findings influenced operative treatment planning in 85% of patients, providing qualitative severity assessment.

Conclusions:

Simultaneous DPG and peritoneography is effective in diagnosing rectal and pelvic floor pathology.
The technique offers a qualitative assessment of pathology severity.
This aids in improved treatment planning for selected patients with obstructed defecation and pelvic prolapse.