Evaluation of pelvic descent disorders by dynamic contrast roentgenography.
OBJECTIVE
For precise diagnosis and rational treatment of the increasing number of patients with descent of intrapelvic organ(s) and anatomic plane(s), dynamic contrast roentgenography of multiple intrapelvic organs and planes is described.


METHODS
Sixty-six patients, consisting of 11 males, with a mean age (+/- standard deviation) of 65.6+/-14.2 years and with chief complaints of intrapelvic organ and perineal descent or defecation problems, were examined in this study. Dynamic contrast roentgenography was obtained by opacifying the ileum, urinary bladder, vagina, rectum, and the perineum. Films were taken at both squeeze and strain phases. On the films the lowest points of each organ and plane were plotted, and the distances from the standard line drawn at the upper surface of the sacrum were measured. The values were corrected to percentages according to the height of the sacrococcygeal bone of each patient. From these corrected values, organ or plane descents at strain and squeeze were diagnosed and graphically demonstrated as a descentgram in each patient.


RESULTS
Among 17 cases with subjective symptoms of bladder descent, 9 cases (52.9 percent) showed roentgenographic descent. By the same token, among the cases with subjective feeling of descent of the vagina, uterus, peritoneum, perineum, rectum, and anus, roentgenographic descent was confirmed in 15 of 20 (75 percent), 7 of 9 (77.8 percent), 6 of 16 (37.5 percent), 33 of 33 (100 percent), 25 of 37 (67.6 percent), and 22 of 36 (61.6 percent), respectively. The descentgrams were divided into three patterns: anorectal descent type, female genital descent type, and total organ descent type.


CONCLUSIONS
Dynamic contrast roentgenography and successive descentgraphy of multiple intrapelvic organs and planes are useful for objective diagnosis and rational treatment of patients with descent disorders of the intrapelvic organ(s) and plane(s).
Takano
M
M
Coloproctology Center, Takano Hospital, Kumamoto, Japan.
Hamada
A
A
D000368:Aged; D003287:Contrast Media / Q000008:administration & dosage; D003937:Diagnosis, Differential; D005242:Fecal Incontinence / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010388:Pelvis / Q000000981:diagnostic imaging / Q000473:pathology; D010502:Perineum / Q000000981:diagnostic imaging; D011859:Radiography; D012005:Rectal Prolapse / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D001745:Urinary Bladder Diseases / Q000000981:diagnostic imaging*; D014596:Uterine Prolapse / Q000000981:diagnostic imaging*
D003287:Contrast Media