Significance of defecography in the diagnosis and evaluation of male patients with defecation disorders.
OBJECTIVE
There are few reports on defecography in male patients with defecation disorders (DD) such as morphological and functional abnormalities (MFA) in the anorectal region. To clarify the significance of defecography in male patients with DD, defecography was performed in the diagnosis and evaluation of DD.


METHODS
The subjects of this study included 37 male patients with DD (group A; aged 15 to 73 years, average 46.5 years). As a control (group B), 30 male healthy volunteers (aged 26 to 66 years, average 46.9 years) were also examined. To perform defecography, we used a plastic pot placed on the elevated footrest of an X-ray table, and evaluated the findings of defecography. A contrast medium (a mixture of barium and wheat flour) was infused into the rectum.


RESULTS
In group A, the incidence of a sense of incomplete emptying of the rectum was significantly greater than that in patients with chronic constipation, difficulty in bowel emptying, perineal pain with defecation, and discomfort in the perineal region (p = 0.0483, p < 0.0001, p < 0.0001, p < 0.0001, respectively). The incidence of bowel habits (once per day) in group B was significantly greater than that that in group A (p < 0.0001). The incidence of defecation with straining in group A was significantly greater than that in group B (p < 0.0001). In group A, the incidences of abnormalities of the levator muscles and abnormalities of the levator muscle with abnormalities in the rectal wall were significantly greater than abnormalities of the rectal wall (p = 0.0049) and normal defecogram (p = 0.1022). The incidence of the normal defecogram in group B was significantly greater than that in group A (p < 0.0001).


CONCLUSIONS
Defecography clearly showed MFA in male patients with DD. Defecography is useful for the diagnosis and evaluation of the MFA in male patients with DD.
Tomita
Ryouichi
R
Department of Surgery, Nippon Dental University Hospital at Tokyo, Japan. rtomita-ndus@mvg.biglobe.ne.jp
Igarashi
Seigo
S
Fujisaki
Shigeru
S
Koshinaga
Tsugumichi
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000000981:diagnostic imaging / Q000503:physiopathology; D001466:Barium Sulfate / Q000008:administration & dosage; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003248:Constipation / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003287:Contrast Media / Q000008:administration & dosage; D019841:Defecography / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012007:Rectum / Q000000981:diagnostic imaging / Q000503:physiopathology
D003287:Contrast Media; D001466:Barium Sulfate