Dyschesia and changes of pubo-rectal angle as observed by 3D ultrasound

Abstract

Objective To discuss the relativity of dyschesia with the change of puborectalismuscle. Methods 68 patients with dyschesia were compared with 68 healthy volunteers at lithotomy position undergoing 3D ultrasonography on resting, contracting and maximum exertion phase respectively. Three dimensionally reconstructed images were reconstructed and pubo-rectal angle and the thickness of puborectalis muscle at 6 o′clock position were measured. Results The pubo-rectal angle of the study group and control group had no significant differences at either resting [(86±8)°vs.(86±8)°] or contracting phases[(88±9)°vs. (86±7)°] (t=-0.145, t=0.434, P>0.05). While at maximum exertion the differences were significant [(80±6)°vs.(95±5)°, t=-5.397, P<0.05]. The d-value of pubo-rectal angle between maximum and resting exertion statistically different [(6±3)°, (-9±7)°, t=5.551, P<0.05]. The thickness of puborectalis muscle between the two groups differed statistically significant only at maximum exertion phase [(4.60±0.60)mm vs. (3.97±0.32)mm, t=6.872, P<0.05]. The d-value of the thickness of puborectalis muscle between maximum and resting exertion were statistically different (t=-11.474, P<0.05). Conclusions The pubo-rectal angle of the study group is smaller at maximum exertion than the control group. The thickness of puborectalis muscle at six o′clock (lithotomy position) in study group is larger at maximum exertion than the control group. And the severity of constipation changed with the variation of angle. Key words: Dysporia; Ultrasonography; Pubo-rectal angle; Thickness of puborectalis muscle