Comparison of 3-Dimensional Pelvic Floor Ultrasonography and Defecography for Assessment of Posterior Pelvic Floor Disorders

Abstract

Purpose: The aim of this study was to determine the accuracy of 3-dimensional (3D) pelvic floor ultrasonography and compare it with defecography in assessment of posterior pelvic disorders.Methods: Eligible patients were consecutive women undergoing 3D pelvic floor ultrasonography at one hospital between August 2017 and February 2019. All 3D pelvic floor ultrasonography was performed by one examiner. A total of 167 patients with suspected posterior pelvic disorder was retrospectively enrolled in the study. The patients were divided into 3 groups according to the main symptoms.Results: There were 82 rectoceles on defecography (55 barium trapping) and 84 on 3D pelvic floor ultrasonography. Each modality identified 6 enteroceles. There were 43 patients with pelvic floor dyssynergia on defecography and 41 on ultrasonography. There were 84 patients with intussusception on defecography and 41 on 3D pelvic floor ultrasonography. Agreement of the 2 diagnostic tests was confirmed using Cohen’s kappa value. Rectocele (kappa, 0.784) and enterocele (kappa, 0.654) both indicated good agreement between defecography and 3D pelvic floor ultrasonography. In addition, pelvic floor dyssynergia (kappa, 0.406) showed moderate agreement, while internal intussusception (kappa, 0.296) had fair agreement.Conclusion: This study showed good agreement for detection of posterior pelvic disorders between defecography and 3D pelvic floor ultrasonography.

Colonic pseudo-obstruction in a patient with dyssynergic defecation: A case report

“…Dyssynergic defecation is the failure to complete a series of defecation processes. The defecation process occurs completely when the abdominal, rectal, pelvic floor, and anal sphincter muscles effectively coordinate [8] , [14] , [15] . One important aspect of childhood development is the acquisition of toileting skills and establishment of continence.…”

Three-Dimensional Pelvic Floor Ultrasound Assessment of Pelvic Organ Prolapse: Minimal Levator Hiatus and Levator Ani Deficiency Score

“…During avulsion, the PR muscle goes through the process of falling from the pubic ramus, and this part becomes the maximal transverse diameter, so avulsion appears more in anterior pelvic floor disorders. In our previous study, 3D pelvic floor ultrasound was useful as an initial test or screening method and for the diagnosis of posterior pelvic disorders [ 34 ]. Furthermore, ultrasound can also be used to diagnose LAM trauma, which is important when choosing treatment and informing patients, as women with major levator trauma are at an increased POP [ 35 ].…”

Is It a Refractory Disease?- Fecal Incontinence; beyond Medication

“…In addition, defecography and pelvic MRI are tests that can detect rectoceles and internal rectal prolapse, as well as see pelvic floor muscle activity during defecation (Fig. 1) [31,32]. Anorectal manometry evaluates the resting and squeezed anal sphincter function of patients [25].…”

“…The response time at the external anal sphincter level is measured. Normal reaction time is 2.0±0.2 PR, puborectalis muscle; PS, pubic symphysis; PV, pubovisceralis muscle; V, vaginal [31]. Adapted from Jeong et al [31] with CC-BY-NC.…”