Radiologic Evaluation of Pelvic Floor Disorders

Savoye‐Collet, Céline; Köning, Edith; Dacher, Jean‐Nicolas

doi:10.1016/j.gtc.2008.06.004

Cited by 33 publications

(28 citation statements)

References 49 publications

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“…It provides useful information about structural changes such as rectoceles, rectal prolapse, and intussusception, and dyssynergic defecation and descending perineum syndrome. 51 However, methodological differences and poor interobserver agreement has limited its overall usefulness. 46 Magnetic resonance (MR) defecography or dynamic pelvic MRI can evaluate pelvic floor anatomy, dynamic motion, and rectal evacuation simultaneously.…”

Section: Defecography and Magnetic Resonance Defecographymentioning

confidence: 99%

Diagnosis and Treatment of Dyssynergic Defecation

Rao

Patcharatrakul

2016

J Neurogastroenterol Motil

189

149

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Dyssynergic defecation is common and affects up to one half of patients with chronic constipation. This acquired behavioral problem is due to the inability to coordinate the abdominal and pelvic floor muscles to evacuate stools. A detailed history, prospective stool diaries, and a careful digital rectal examination will not only identify the nature of bowel dysfunction, but also raise the index of suspicion for this evacuation disorder. Anorectal physiology tests and balloon expulsion test are essential for a diagnosis. Newer techniques such as high-resolution manometry and magnetic resonance defecography can provide mechanistic insights. Recently, randomized controlled trials have shown that biofeedback therapy is more effective than laxatives and other modalities, both in the short term and long term, without side effects. Also, symptom improvements correlated with changes in underlying pathophysiology. Biofeedback therapy has been recommended as the first-line of treatment for dyssynergic defecation. Here, we provide an overview of the burden of illness and pathophysiology of dyssynergic defecation, and how to diagnose and treat this condition with biofeedback therapy.

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Section: Defecography and Magnetic Resonance Defecographymentioning

confidence: 99%

Diagnosis and Treatment of Dyssynergic Defecation

Rao

Patcharatrakul

2016

J Neurogastroenterol Motil

189

149

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“…It is performed by infusing 150 mL of contrast into the patient's rectum, and having the subject squeeze, cough, and expel the barium. The most common findings are poor activation of levator ani muscles, prolonged retention or inability to expel the barium, absence of a stripping wave in the rectum, mucosal intussusceptions, and / or rectocele [36, 37]. The prevalence of normal defecography varied between 10% and 75% [36].…”

Section: Diagnostic Testsmentioning

confidence: 99%

“…The prevalence of normal defecography varied between 10% and 75% [36]. Although defecography revealed abnormalities in 77% of subjects, there was no relationship between symptoms and abnormalities [37]. Among 10 studies, abnormalities were reported in 25% to 90% and dyssynergia in 13% to 37% [5].…”

Section: Diagnostic Testsmentioning

confidence: 99%

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What is necessary to diagnose constipation?

Rao

Meduri

2011

Best Practice & Research Clinical Gastroenterology

112

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Constipation is a common ailment with multiple symptoms and diverse etiology. Understanding the pathophysiology is important to guide optimal management. During the past few years, there have been remarkable developments in the diagnosis of constipation and defecation disorders. Several innovative manometric, neurophysiologic, and radiologic techniques have been discovered, which have improved the accuracy of identifying the neuromuscular mechanisms of chronic constipation. These include use of digital rectal examination, Bristol stool scale, colonic scintigraphy, wireless motility capsule for assessment of colonic and whole gut transit, high resolution anorectal manometry, and colonic manometry. These tests provide a better definition of the underlying mechanism(s), which in turn can lead to improved management of this condition. In this review, we summarize the recent advances in diagnostic testing with a particular emphasis on when and why to test, and discuss the utility of diagnostic tests for chronic constipation.

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“…As lymphedema been discovered often by chance and has no reported common elements, it has been difficult to create an experimental model (Savoye-Collet et al, 2008). Here, we attempted to generate a diagnostic model by exploiting the radiological resources available in our laboratory.…”

Section: Clinical Evidence Of Pelvic Lymphedemamentioning

confidence: 99%