Dynamic magnetic resonance imaging evaluation of the structural and functional results of postanal repair for neuropathic fecal incontinence.
OBJECTIVE
The aim of this study was to determine whether dynamic magnetic resonance imaging of the pelvic floor can discriminate between patients who improve after postanal repair for neurogenic fecal incontinence and those who remain symptomatic.


METHODS
Pelvic floor measurements obtained during dynamic magnetic resonance imaging in eight females whose anal incontinence had improved after postanal repair were compared with those from nine females who remained symptomatic. All subjects also underwent standard anorectal physiology testing.


RESULTS
There was no significant difference between groups with respect to any measurement of anterior or middle pelvic floor compartments. Additionally, there was no difference in posterior pelvic floor configuration when symptomatic patients were compared with those who had improved. However, dynamic magnetic resonance measurements revealed patients who remained symptomatic had significantly greater posterior pelvic floor weakness. Anorectal physiology was unable to differentiate between groups.


CONCLUSIONS
There is no difference in static pelvic floor measurements when subjects remaining symptomatic after postanal repair are compared with those who have improved. In contrast, dynamic measurements may be able to predict failure in those who demonstrate excessive posterior pelvic floor mobility.
Healy
Jeremiah C
JC
Department of Radiology, Chelsea & Westminster Hospital, London, United Kingdom.
Halligan
Steve
S
Bartram
Clive I
CI
Kamm
Michael A
MA
Phillips
Robin K S
RK
Reznek
Rodney
R
D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000601:surgery*; D005242:Fecal Incontinence / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017773:Pelvic Floor / Q000000981:diagnostic imaging / Q000502:physiology*; D011237:Predictive Value of Tests; D011859:Radiography; D016896:Treatment Outcome