Publication details
Jak správně diagnostikovat anorektální dysfunkci, když jen klinika nestačí?
| Title in English | How to correctly diagnose anorectal dysfunction when clinical evaluation alone is insufficient? |
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| Year of publication | 2025 |
| Type | Conference abstract |
| Citation | |
| Description | Introduction and aims: Pelvic floor dysfunction represents a complex problem affecting predominantly women and significantly influencing their quality of life. The aim of our retrospective study was to evaluate the benefit of dynamic MRI defecography in the diagnostic algorithm of anorectal dysfunctions. Methods: In 40 female patients examined at the colorectal outpatient clinic of the 1st Department of Surgery, St. Anne’s University Hospital in Brno, during the period 9/2022–5/2023, the relationship between subjective symptoms, clinical findings, results of high-resolution anorectal manometry, and findings on MRI defecography was evaluated. The study results were statistically processed using the Statistica 12.0 program. Results: The primary complaints for which the patients visited our outpatient clinic were constipation in 60% of patients, fecal incontinence in 33%, one patient complained of proctalgia, and two patients had rectal prolapse. On clinical examination, 20% of patients had rectoanal intussusception present and 15% had complete rectal prolapse. Thirty-six percent of patients reported concomitant urinary incontinence. The results show a high degree of correlation between subjective complaints (incontinence, constipation), clinical examination, and MRI findings (e.g., rectocele, enterocele, rectal prolapse). MRI defecography did not demonstrate descent of the anterior compartment (p = 0.061) nor cystocele (p = 0.003) in patients without concomitant urinary incontinence. In cases of a physiological finding of the pelvic floor in the anterior compartment according to MRI defecography, a trend toward concordance (p = 0.109) with a physiological value of the internal sphincter on anorectal manometry was demonstrated. Patients with physiological values on anorectal manometry had complete rectal evacuation on MRI defecography (p = 0.0598). Conclusion: The diagnosis of anorectal dysfunctions requires close interdisciplinary cooperation among gastroenterologists, radiologists, surgeons, gynecologists, and urologists. Dynamic MRI defecography was confirmed in our study as a reliable and beneficial imaging method that allows detailed and objective evaluation of both structural and functional abnormalities of the pelvic floor, especially in the detection of pathology involving multiple compartments. Precisely due to effective interdisciplinary cooperation, it is possible to correctly interpret examination results and propose an individualized therapeutic approach, which is key to achieving an optimal treatment outcome. |