Defecatory disorders as obstructed defecation syndrome (ODS) and fecal incontinence are prevalent among ageing women, particularly multiparous ones. Usually such patients present with symptoms denoting dysfunctions in the posterior compartment only. Undiagnosed associated disorders in other compartments could lead to failure of cessation of symptoms postoperatively after single-compartment surgical correction approach. Simplifying the diagnosis depending on clinical examination and conventional defecography studies has lead to numerous need for re-operations in the past. Recent advancements in surgical approaches -whether trans-abdominal, trans-anal or combined, with the advent...

Patient population: thirty-five (aged 25-74 years, mean age 43.9 ± 13.8) multiparous (mean parity 2.8 ± 1.2) female patients (4 of them had previous hysterectomies) with primary anorectal dysfunction symptoms (obstructed defecation syndrome 28, fecal incontinence 7) with no associated urogynecological complaints were referred for preoperative MRD assessment. Patient preparation: All patients underwent rectal enema the night before the MRI examination. No fasting pre examination was required. Patients were asked not to void 2 hours before the examination. Explanation of the technique and training of...

All patients had apparent posterior compartment abnormalities manifested by puborectalis dyskinesia, excessive anorectal junction descent and/or rectocele or rectal intussusception. Global pelvic floor descent (pelvic organ prolapse) involving all three pelvic floor compartments was found in 14 (40%) patients exhibiting associated cystocele and uterine descent. Associated anterior compartment involvement was found in 7 (20%) patients showing cystocele. Concomitant middle compartment abnormalities were found in 4 patients: 2 (6%) patients having associated uterine descent while enterocele was found in 2 (6%) patients. Posterior compartment dysfunctions with...

MR defecography is an excellent one-stop-shop study of the pelvic floor offering a state-of-the-art assessment for patients with anorectal disorders, unleashing hidden pelvic floor dysfunctions in multiparous females presenting with obstructed defecation syndrome and fecal incontinence symptoms. MRD provides a reliable preoperative evaluation of the underlying anatomical and functional defects, especially when involve­ment of multiple compartments is suspected, altering the understanding of pelvic floor disorders, and suggesting an apt scheme of management tailored for each individual case.

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