Article Sidebar
Views PDF: 169
Evaluation of rectocele in patients with pelvic floor dysfunction by dynamic magnetic resonance imaging
Main Article Content
Abstract
SUMMARY
Objectives: Rectocele is a bulge or a prolapse of the anterior
rectal wall into the posterior vaginal wall. It is relatively common
with diversified and nonspecific symptoms. Clinical examination is
easily confused and/or sometimes omitted the prolapse of other
pelvic organs. Imaging to assess the pelvic floor dysfunction is an
important and useful diagnostic test, especially dynamic MR.
Methods: Our study was cross-sectional descriptive. Patients with pelvic floor dysfunction were undergone clinical examinations
and then were indicated to have dynamic MR scanning at Ho Chi
Minh City Medical University by anorectic doctor, urologist and
gynecologist.
Results: 1.863 patients were evaluated from January 2008 to June 2012. Most of them are women, middle-aged and used to give birth. The rate of rectocele with its depth from 2 to 4 cm was 77.9%, mainly with the shape of “finger”. The depth of more than 2 cm with the shape of “bag” has the high risk of stagnancy. The factor of age and being used to give birth have a significant relation with rectocele (p<0.001). The rate of rectocele in the group of anismus was 64.2%. The combination of the prolapse of more than one pelvic chamber accounted for 77.4% (p<0.001).
Conclusions: Dynamic MR of the pelvic floor helps to diagnose in details the characteristics of the rectocele and other pelvic organ prolapse, helping clinicians to choose the appropriate treatments.
Article Details
References
1. Mellgren A, Anz‚n B, Nilsson B-Y(1995). Results of rectocele repair, a prospective study. Dis Colon Rectum, 38:764-8.
2. Sarles JC, Arnaud A, Sielezneff I, Olivier S (1989). Endo-rectal repair of rectocele. Int J Colorectal Dis, 4:167-71.
3. Halligan S, Bartram CI (1995). Is Barium trapping in rectoceles significant? Dis Colon Rectum, 38:764-8.
4. Van Dam JH, Ginai AZ, Gosselink MJ (1997). Role of defecography in predicting clinical outcome of rectocele repair.Dis Colon Rectum, 40:201-7.
5. Yang A, Mostwin JL, Rosenshein NB, Zerhouni EA (1991). Pelvic floor descent in women: dynamic evaluation with fast MR imaging and cinematic display. Radiology,179:25–33.
6. Kruyt RH, Delemarre JB, Doornbos J, Vogel HJ (1991). Normal anorectum: dynamic MR imaging anatomy. Radiology, 179:159–163.
7. Andrew Yang, Jacek L. Mostwin, Neil B. Rosenshein (1991). Pelvic Floor Descent in Women: Dynamic Evaluation with Fast MR Imaging and Cinematic Display. Radiology, 179(1): 25-33.
8. Jeremiah C. Healy, Stephen Halligan, Rodney H. Reznek (1997). Dynamic MR Imaging Compared with Evacuation Proctography when Evaluating Anorectal
Configuration and Pelvic Floor Movement. AJR, 169: 775-779.
9. Fustus E.Roos, Dominik Weishaupt, Simon Wildermuth (2002). Experience of 4 Years with Open MR Defecography: Pictorial Review of Anorectal Anatomy and Disease. RadioGraphics, 22: 817-832.
10. Julie R.Fielding (2002). Practical MR Imaging of Female Pelvic Floor Weakness. RadioGraphics 22:295-304.
11. Lamb GM, De Jode MG, Guold SW (2000). Upright dynamic MR defeacating proctography in an open configuration MR system. The British Journal of Radiology 73:152-155.
12. Zoran L. Barbaric, Alan K. Marumoto (2001). MRI of the Perineum and Pelvic Floor. Topic in Magnetic Resonance Imaging 12:83-92.
13. Chu WC, Tam YH, Lam WW (2007). Dynamic MR assessment of the anorectal angle and puborectalis muscle in pediatric patients with anismus: Technique and feasibility. J Magn Reson Imaging 25:1067-72.
14. Reginald Goei, Gerrit Kemerink (1990). Radiation Dose in Defecography. Radiology 176:137- 39.
15. Nguyễn Thị Thùy Linh, Võ Tấn Đức, Phạm Ngọc Hoa (2008). Vai trò của cộng hưởng từ động vùng sàn chậu trong chẩn đoán rối loạn sự thoát phân. Tạp
chí Y học Việt Nam, 349:85-89.
16. Nguyễn Thị Thùy Linh, Võ Tấn Đức, Phạm Ngọc Hoa (2009). Cộng hưởng từ động trong đánh giá các bệnh lý vùng sàn chậu. Tạp chí Y học TPHCM, 13:292-297.
17. Nguyễn Trung Vinh (2010). Nhận xét bước đầu phẫu thuật phục hồi bản sau cơ nâng hậu môn trong điều trị hội chứng sa sàn chậu. Tạp chí Y học TPHCM, 14:263-268.
18. Smith AR (1994). Role of connective tissue and muscle in pelvic floor dysfunction. Curr Opin Obstet Gynecol, 6:317-19.
19. Siproudhis L., Dautrème S. (1993). Dyschezia and rectocele-a marriage of convenience? Physiologic evaluation of the rectocele in a group of 52 women
complaining of difficulty in evacuation. Dis Colon Rectum, 36:1030-6.
20. Johansson C, Nilsson BY (1992). Association between rectocele paradoxical sphincter response. Dis Colon Rectum, 35:503-9.
21. Yoshioka K, Matsui Y, Yamada O (1991). Physiologic and anatomic assessment of patients with rectocele. Dis Colon Rectum, 34:704-8.