[Application of pelvic floor dynamic MRI combining defecography with homemade high conformable sacculus in the management of obstructed defecation syndrome].
OBJECTIVE
To evaluate the sensitivity and feasibility of pelvic floor dynamic MRI combining defecography with homemade high conformable sacculus in the management of obstructed defecation syndrome.


METHODS
One hundred and nine female with pelvic floor disorders, such as difficult defecation, fecal incontinence or urinary incontinence, pelvic pain, were treated from July 2007 to March 2009. Pelvic floor dynamic MRI and defecography with homemade high conformable sacculus was performed in the patients to evaluate pelvic floor anatomy.


RESULTS
Fifty-four cases (49.6%) of cystocele and 11 cases (10.1%) of rectouterine pouch hernia, 29 cases (26.6%) of perineum prolapse and 71 cases (65.2%) of rectocele were found by dynamic MRI. The dynamic MRI also revealed 19 cases (18.2%) of external sphincter trophy and 32 cases (29.4%) of spastic pelvic floor syndrome. Compared with defecography, dynamic MRI was more positive in diagnosing enterocele. Defecography Of the patients, sacrum-rectal separate was found in 33 cases (30.3%) and rectal mucosal prolapse or internal rectal intussusceptions in 41 cases (37.7%) by defecography, while dynamic MRI found none.


CONCLUSIONS
As a new noninvasive imaging technique to evaluate the pelvic floor function, dynamic MRI is more sensitive, especially for patients with complicated multi-organs prolapse, and its deficiency could be remedied by defecography.
Song
Wei-liang
WL
Department of General Surgery, Chaoyang Hospital Affiliated to Capital Medical University, Beijing 100020, China. songwl2008@sina.com
Wang
Zhen-jun
ZJ
Zheng
Yi
Y
Yi
Bing-qiang
BQ
Yang
Xin-qing
XQ
Jiang
Tao
T
D000328:Adult; D000368:Aged; D003248:Constipation / Q000175:diagnosis* / Q000503:physiopathology; D019841:Defecography; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D017773:Pelvic Floor / Q000503:physiopathology; D012680:Sensitivity and Specificity; D055815:Young Adult