Defecography: I. Description of a new procedure and results in normal patients

Mahieu, Pierre; Pringot, Jacques; Bodart, P

doi:10.1007/bf01887845

Cited by 370 publications

(139 citation statements)

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“…O AAR foi mensurado utilizando-se o método descrito por Mahieu et al (4) , obtido através da interseção das retas traçadas pelo eixo do canal anal e da parede póstero-inferior do reto (Figura 1).…”

Section: Casuística E Métodosunclassified

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Avaliação do ângulo ano-retal por meio de defecograma em voluntárias assintomáticas nulíparas e multíparas

et al. 2003

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Santos JEM et al. Radiol Bras 2003;36(4):219224 219 INTRODUÇÃOEste trabalho objetivou preencher uma lacuna na literatura nacional a respeito do exame de defecograma e comparar os achados radiográficos obtidos entre nulíparas e multíparas assintomáticas, assunto pouco explorado na literatura mundial.As primeiras tentativas de estudo dos mecanismos da defecação tiveram início na década de 60(1-3 OBJETIVO: Fizemos um protocolo para compararmos as medidas dos ângulos ano-retais em três situações diferentes, em voluntárias assintomáticas nulíparas e multíparas. CASUÍSTICA E MÉTODOS: Foram realizados defecogramas em 30 mulheres (15 nulíparas e 15 multíparas), de maio de 1997 a dezembro de 1998, e obtidas incidências radiográficas em perfil do reto após introdução de contraste baritado texturizado: em repouso, durante contração do músculo puborretal e durante a evacuação. Na análise estatística foi utilizada a análise de medidas repetidas. RESULTADOS: A média do ângulo não apresentou diferença significante entre as voluntárias nulíparas e multíparas. O ângulo mediu, nas nulíparas, 92,9° em repouso, 78,8°d urante a contração do músculo puborretal e 117,9° durante a evacuação, e nas multíparas mediu 94,3°e m repouso, 79,7° durante a contração do músculo puborretal e 121,4° durante a evacuação. Foi observada diferença significante entre os ângulos em repouso, durante a contração do músculo puborretal e durante a evacuação. CONCLUSÃO: Não houve diferença significante entre os dois grupos examinados. Unitermos: Defecografia; Ânus; Reto; Defecação; Pelve; Feminino.Measurement of the anorectal angle by defecography in asymptomatic nulliparous and multiparous volunteers. OBJECTIVE: We developed a protocol to compare the measurements of the anorectal angle in nulliparous and multiparous asymptomatic volunteers in three different situations. SUBJECTS AND METHODS: Defecograms were carried out in 30 women (15 nulliparous and 15 multiparous) from May, 1997 to December, 1998. After rectal administration of texturized barium contrast media, lateral radiographic views of the rectum were obtained at rest, during contraction of the puborectal muscle and during defecation. A repeated measures model was used for the statistical analysis. RESULTS: There were no significant differences between the mean anorectal angles of nulliparous and multiparous volunteers. Measurements were as follows: 92.9° at rest, 78.8° during the contraction of the puborectal muscle and 117.9° during defecation for the nulliparous volunteers; 94.3° at rest, 79.7° during the contraction of the puborectal muscle and 121.4° during defecation for the multiparous volunteers. A significant difference was observed between the anorectal angle measurements at rest, during contraction of the puborectal muscle and during defecation. CONCLUSION: There were no significant differences between the anorectal angle measurements of the two groups of volunteers examined. A média do ângulo ano-retal (AAR) normal observada pelos autores foi de 92° (± 1,52 EMP) em repouso e de 137° (± 1...

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Section: Casuística E Métodosunclassified

“…No início da década de 80, Mahieu et al (4,5) publicaram estudos em que simplificavam os métodos de estudo anteriormente descritos, diminuindo o tempo e o custo do exame e apresentando medidas objetivas da função evacuatória.…”

Section: Introductionunclassified

Avaliação do ângulo ano-retal por meio de defecograma em voluntárias assintomáticas nulíparas e multíparas

et al. 2003

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“…Radiologic methods for the dynamic evaluation of the obstruc ted defecation syndrome (ODS) include defecography, magnetic resonance imaging and ultrasonography, each of which has its advantages and limitations (4,5,6,10,14,20,22,24,25,28,32) . Different dynamic ultrasound techniques have been used to evaluate pelvic floor dysfunctions and demonstrated good correlation with conventional defecography (4,6,10,28) .…”

Section: Introductionmentioning

confidence: 99%

Management of patients with rectocele, multiple pelvic floor dysfunctions and obstructed defecation syndrome

Murad-Regadas

Regadas

Rodrigues

et al. 2012

Arq. Gastroenterol.

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-Context -Management of patients with obstructed defecation syndrome is still controversial. Objective -To analyze the efficacy of clinical, clinical treatment followed by biofeedback, and surgical treatment in patients with obstructed defecation, rectocele and multiple dysfunctions evaluated with echodefecography. Methods -The study included 103 females aged 26-84 years with obstructed defecation, grade-II/III rectocele and multiple dysfunctions on echodefecography. Patients were distributed into three treatment groups and constipation scores were assigned. Group I: 34 (33%) patients with significant improvement of symptoms through clinical management only. Group II: 14 (14%) with improvement through clinical treatment plus biofeedback. Group III: 55 (53%) referred to surgery due to treatment failure. Results -Group I: 20 (59%) patients had grade-II rectocele, 14 (41%) grade-III. Obstructed defecation syndrome was associated with intussusception (41%), mucosal prolapse (41%), anismus (29%), enterocele (9%) or 2 dysfunctions (23%). The average constipation score decreased significantly from 11 to 5. Group II: 11 (79%) grade-II rectocele, 3 (21%) grade-III, associa ted with intussusception (7%), mucosal prolapse (43%), anismus (71%) or 2 dysfunctions (29%). There was significant decrease in constipation score from 13 to 6. Group III: 8 (15%) grade-II rectocele, 47 (85%) grade-III, associated with intussusception (42%), mucosal prolapse (40%) or 2 dysfunctions (32%). The constipation score remained unchanged despite clinical treatment and biofeedback. Twenty-three underwent surgery had a significantly decrease in constipation score from 12 to 4. The remaining 32 (31%) patients which 22 refused surgery, 6 had low anal pressure and 4 had slow transit. Conclusions -Approximately 50% of patients with obstructed defecation, rectocele and multiple dysfunctions presented a satisfactory response to clinical treatment and/or biofeedback. Surgical repair was mainly required in patients with grade-III rectocele whose constipation scores remained high despite all efforts. HEADINGS -Rectocele. Constipation. Pelvic floor. Imaging, three-dimensional.None disclosure.

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“…During recent decades, interest in the study of evacuation has grown; today it can also be performed with magnetic resonance imaging (MRI). Nonetheless, this technique still represents a widely available and cost-effective diagnostic tool (2)(3)(4)(5)(6)(7).…”

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confidence: 99%

“…Defecography evaluates in real time the morphology of rectum and anal canal in correlation with pelvic bony components both statically and dynamically by injection of a thick barium paste into the rectum and its subsequent evacuation (2)(3)(4)(5). The most common indications are constipation, incomplete evacuation or incontinence (often associated with rectal bleeding), mucous discharge, and perineal pain or discomfort.…”

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Defecography: a practical approach

Faccioli¹,

Comai²,

Mainardi³

et al. 2009

Diagn Interv Radiol

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The purpose of this pictorial essay is to describe the main morpho-functional imaging features, physiological and pathological, of the recto-anal region and pelvic floor as depicted with conventional video defecography.Defecography has dramatically improved our knowledge of dysfunctions of evacuation. The most frequent indications and related disorders are presented from a database of more than 2500 examinations conducted in two radiology departments over a period of 15 years.Imaging features of the common recto-anal and pelvic floor disorders are described: rectal prolapse, rectocele, intussusception, descending pelvic floor syndrome, puborectalis muscle syndrome, enterocele, and sigmoidocele. Conventional video defecography still represents the gold standard examination for the identification and staging of morphological and functional disorders of the recto-anal region and pelvic floor in evacuation dysfunctions.

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Defecography: I. Description of a new procedure and results in normal patients

Cited by 370 publications

References 3 publications

Avaliação do ângulo ano-retal por meio de defecograma em voluntárias assintomáticas nulíparas e multíparas

Avaliação do ângulo ano-retal por meio de defecograma em voluntárias assintomáticas nulíparas e multíparas

Management of patients with rectocele, multiple pelvic floor dysfunctions and obstructed defecation syndrome

Defecography: a practical approach

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