title: Functional imaging of the pelvic floor.
abstract: The clinical treatment of patients with anorectal and pelvic floor dysfunction is often difficult. Dynamic cystocolpoproctography (DCP) has evolved from a method of evaluating the anorectum for functional disorders to its current status as a functional method of evaluating the global pelvic floor for defecatory disorders and pelvic organ prolapse. It has both high observer accuracy and a high yield of positive diagnoses. Clinicians find it a useful diagnostic tool that can alter management decisions from surgical to medical and vice versa in many cases. Functional radiography provides the maximum stress to the pelvic floor, resulting in levator ani relaxation accompanied by rectal emptying-which is needed to diagnose defecatory disorders. It also provides organ-specific quantificative information about female pelvic organ prolapse-information that usually can only be inferred by means of physical examination. The application of functional radiography to the assessment of defecatory disorders and pelvic organ prolapse has highlighted the limitations of physical examination. It has become clear that pelvic floor disorders rarely occur in isolation and that global pelvic floor assessment is necessary. Despite the advances in other imaging methods, DCP has remained a practical, cost-effective procedure for the evaluation of anorectal and pelvic floor dysfunction. In this article, the authors describe the technique they use when performing DCP, define the radiographic criteria used for diagnosis, and discuss the limitations and clinical utility of DCP.
authors.affiliation: Department of Radiology, Indiana University School of Medicine, Indiana University Hospital, 550 N University Blvd, UH0279, Indianapolis, IN 46202-5253, USA. dmaglint@iupui.edu
authors.forename: Dean D T
authors.initials: DD
authors.lastname: Maglinte
authors.forename: Clive I
authors.initials: CI
authors.lastname: Bartram
authors.forename: Douglass A
authors.initials: DA
authors.lastname: Hale
authors.forename: Jean
authors.initials: J
authors.lastname: Park
authors.forename: Marc D
authors.initials: MD
authors.lastname: Kohli
authors.forename: Bruce W
authors.initials: BW
authors.lastname: Robb
authors.forename: Stefania
authors.initials: S
authors.lastname: Romano
authors.forename: John C
authors.initials: JC
authors.lastname: Lappas
mesh_terms: D001003:Anal Canal / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D003127:Colposcopy / Q000379:methods; D003287:Contrast Media; D052858:Cystocele / Q000000981:diagnostic imaging / Q000503:physiopathology; D003558:Cystoscopy / Q000379:methods; D019841:Defecography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D017773:Pelvic Floor / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D056887:Pelvic Organ Prolapse / Q000000981:diagnostic imaging / Q000503:physiopathology; D010808:Physical Examination; D020047:Rectocele / Q000000981:diagnostic imaging / Q000503:physiopathology
chemical_list: D003287:Contrast Media