Evacuation proctography: An investigation of rectal expulsion in 20 subjects without defecatory disturbance

Bartram, Clive I.; Turnbull, Geoffrey K.; Lennard‐Jones, J. E.

doi:10.1007/bf01889028

Cited by 209 publications

(74 citation statements)

References 12 publications

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“…Dyssynergic defecation includes paradoxical contraction or the inability to relax the pelvic floor musculature resulting in a lack of descent of the pelvic floor, a failure to increase the ARA and potentially a prominent impression of the puborectal sling [3,5,11]. Although the decrease in the ARA during straining is considered a typical sign of dyssynergic defecation, other studies with conventional defecography could not confirm this finding [8], and other authors also found this sign in asymptomatic volunteers [26,27]. A recent study [16] on dynamic MR in paediatric patients with dyssynergic defecation described significant differences with regard to the ARA during straining and with regard to the ARA-change on straining between patients with dyssynergic defecation and healthy controls.…”

Section: Discussionmentioning

confidence: 99%

MR defecography in patients with dyssynergic defecation: spectrum of imaging findings and diagnostic value

Reiner¹,

Tutuian²,

Solopova³

et al. 2011

BJR

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Objectives: We describe the spectrum of findings and the diagnostic value of MR defecography in patients referred with suspicion of dyssynergic defecation. Methods: 48 patients (34 females, 14 males; mean age 48 years) with constipation and clinically suspected dyssynergic defecation underwent MR defecography. Patients were divided into patients with dyssynergic defecation (n518) and constipated patients without dyssynergic defecation (control group, n530). MRIs were analysed for evacuation ability, time to initiate evacuation, time of evacuation, changes in the anorectal angle (ARA-change), presence of paradoxical sphincter contraction and presence of additional pelvic floor abnormalities. Sensitivity, specificity, positive and negative predictive values and accuracy for the diagnosis of dyssynergic defecation were calculated. Results: The most frequent finding was impaired evacuation, which was seen in 100% of patients with dyssynergic defecation and in 83% of the control group, yielding a sensitivity for MR defecography for the diagnosis of dyssynergic defecation of 100% (95% confidence interval (CI) 97-100%), but a specificity of only 23% (95% CI 7-40%). A lower sensitivity (50%; 95% CI 24-76%) and a high specificity (97%; 95% CI 89-100%) were seen with abnormal ARA-change. The sensitivity of paradoxical sphincter contraction was relatively high (83%; 95% CI 63-100%). A combined analysis of abnormal ARA-change and paradoxical sphincter contraction allowed for the detection of 94% (95% CI 81-100%) of the patients with dyssynergic defecation. Conclusion: MR defecography detects functional and structural abnormal findings in patients with clinically suspected dyssynergic defecation. Impaired evacuation is seen in patients with functional constipation owing to other pelvic floor abnormalities than dyssynergic defecation.

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Section: Discussionmentioning

confidence: 99%

MR defecography in patients with dyssynergic defecation: spectrum of imaging findings and diagnostic value

Reiner¹,

Tutuian²,

Solopova³

et al. 2011

BJR

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“…Constipation in these patients may be due to personality parameters and stress. Also, structural abnormalities of the anorectum, such as rectocele and hidden rectal prolapse, are common in asymptomatic patients [16]. Examination and management of patients with severe constipation is often complicated and confusing, particularly in patients who demonstrate combined slow transit constipation and disordered defecation.…”

Section: Methodsmentioning

confidence: 99%

Is constipation a disorder of defecation or impaired motility?: distinction based on defecography and colonic transit studies.

Karasick

Ehrlich²

1996

American Journal of Roentgenology

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“…(27) Goei et al, 1989 (28) Shorvon et al, 1989 (29) Freimanis et al, 1991 (19) Mezwa et al, 1993 (18) Somers, 1994 (9) Ikenberry et al, 1996 …”

Section: Conclusãomentioning

confidence: 99%

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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Evacuation proctography: An investigation of rectal expulsion in 20 subjects without defecatory disturbance

Cited by 209 publications

References 12 publications

MR defecography in patients with dyssynergic defecation: spectrum of imaging findings and diagnostic value

MR defecography in patients with dyssynergic defecation: spectrum of imaging findings and diagnostic value

Is constipation a disorder of defecation or impaired motility?: distinction based on defecography and colonic transit studies.

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

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