Purpose
Pelvic floor disorders represent a significant cause of morbidity associated with a severe reduction of quality of life.
It represent a very common clinical problem that afflicts women three to seven times more often than man(1,2) .
Even if the the entero-colpo-cysto-defecography (ECCD) is considered the gold standard for patient with enterocele,
the role of MR is discussed (3).
The purposes of this study were to assess the diagnostic tools available to define the imaging strategy in case of pelvic floor dynamic dysfunctions and to...
Methods and Materials
From 2008 to 2011,
2711 patients with symptoms related to pelvic floor dynamic dysfunctions were enrolled in a retrospective study.
Male patients,
that represented about 10% of cases,
were excluded from the study.
The mean age of women in the study was of 57,3.
Patients were divided into three groups: nulliparous,
multiparous and women with prior hysterectomy.
Referral symptoms varied from constipation and obstructed defecation to incontinence.
After anamnesis and clinical examination entero-colpo-cysto-defecography (ECCD) was performed in all patients,
supine entero-MRI (SE-MRI) in patients with...
Results
According with other authors (4) our results with chi-square analyses show that women with multiparity or a prior hysterectomy are more likely to reveal enterocele and pelvic floor descent.
On 2439 ECCD performed,
enterocele (fig.
1,
fig.2) was diagnosed in 241 patients and 7 patients showed elytroceles and 9 edroceles.
Patients with positive ECCD findings underwent a SE-MRI,
too.
Both examination were analyzed by two expertise investigators blinded against the clinical data and against the results of the other imaging technique .
Our results show...
Conclusion
CONCLUSION
This study showed a moderate agreement between ECCD and SE-MRI.
The diagnostic efficacy of ECCD is higher than that of SE-MRI in the detection of enterocele and edrocele.
These results emphasize the role of ECCD in the diagnosis of pelvic floor disorders,
in accordance with other authors (5,6).Furthermore elytrocele can be visualized only with ECCD considering the position of patient during SE-MR examination.
In patients planned for surgery,
considering the frequent association of defecatory disorders with pelvic organ prolapse,
MR could be more useful...
References
1.
Comparison between dynamic cystocolpoproctography and dynamic pelvic floor MRI: pros and cons: Which is the "functional" examination for anorectal and pelvic floor dysfunction? Maglinte,
DD,
Hale,
DS e Sandrasegaran,
K.
2012,
Abdom Imaging,
[Epub ahead of print].
2.
Gastrointestinal disorders in elderly patients.
Reginelli A,
Pezzullo MG,
Scaglione M,
Scialpi M,
Brunese L,
Grassi R..
2008 ,
Radiol Clin North Am,
46(4):755-71.
3.
Dynamic MRI defecography vs.
entero-colpo-cysto-defecography in the evaluation of midline pelvic floor hernias in female pelvic floor disorders.
Cappabianca S,
Reginelli...