Abstract
Evacuation proctography or defecography is a long-established and relatively straightforward diagnostic procedure for the investigation of those with symptoms of rectal outlet obstruction. Controversy exists as to the interpretation and clinical utility of the technique largely due to absent or imperfect reference standards for comparison. However, when interpreted sensibly, proctography still has a very important role in patient management, particularly in therapeutic triage. A simplistic (but effective) interpretative approach is to firstly assess the speed and completeness of evacuation (abnormality of which largely suggests an underlying functional problem) and then to describe any structural problems, documenting whether they are likely primary or secondary.
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