MR defecography in obstructed Defecation syndrome

Abstract

Abstract Background ODS is an emerging clinical problem, especially for adult female patients (80%–90%). The pathophysiology of ODS remains to be clearly defined. This is because anatomic defects, such as internal rectal prolapse and rectocele, may be associated with functional alterations, such as paradoxical puborectalis contraction and spastic external sphincter contraction. Aim of the Work Obstructed defecation syndrome (ODS) is a type of constipation characterized by fragmented stools, need for straining at defecation, sense of incomplete evacuation, tenesmus, urgency and pelvic heaviness. This study is aimed to assess and compare and matching the role of Dynamic magnetic resonance imaging (MRI defecography) with the cilincal diagnosis in such patients. Pateints and Methods This retrospective, case-control study was conducted on twenty patients suffering from obstructive defecation syndrome that have been diagnosed clinically. The patients age is ranged between 16 and 69 years old. Results Statistically MRI study showed significant anatomical defects (p < 0.05) as the followings: Most of patients had Rectocele (65%), Disenergic Pelvic Syndrome (DPS) because of pelvic floor descents in (55%) of patients. Intossusception(45%),Cystocele (30%), interocele(25%), Anismus(15%) and uterine prolapsed (15%) Conclusion MRI has good value to detect abnormalities pertinent to posterior compartment in pelvis. Results of MR imaging showed positive agreement with clinical diagnosis of ODS in65% of patients. MRI showed 90% sensitivity, specificity, positive and negative predictive values as well as accuracy. MRI assessment of the posterior pelvic compartment can be indicated to detect the anatomical defects and lead to more successfully patient management and subsequently decreases the rate of postoperative recurrence.