Role of three-dimensional ultrasound in females with obstructed defecation (in comparison with defecography)

Mahmoud Abdel Latif,Waleed M Thabet,Magda Shady,Nahla M Elawadly

doi:10.1186/s43055-019-0116-6

Mahmoud Abdel Latif, Waleed M Thabet + Show 2 more

Open Access

https://doi.org/10.1186/s43055-019-0116-6

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Abstract

BackgroundGrowing attention of pelvic floor disorders has led to development of new imaging techniques, with increasing importance of ultrasonography. The 3DUS technique is considered an accessible tool for imaging of the posterior pelvic compartment. The purpose of this study is to highlight the role of 3D ultrasound in evaluation of obstructed defecation in females and comparing the findings with defecography.ResultsStudy included 30 females classified into two groups: (1) 20 patients (case group complaining of obstructed defecation); (2) ten females (control group-normal nulliparous females). All of them were subjected to defecography and 3D ultrasound during resting, squeezing, and straining. Detection rate of rectocele and intussusception with 3D ultrasound was lower than defecography. By US, significant statistical difference between patients and controls in all measurements of levator hiatus, IS, ES, and PRS thickness during straining (P value < 0.001). During straining, cut-off value of 20.75 cm2 for hiatal area gives sensitivity of 100% and specificity of 95% and using ARA, cut-off value of 105° gives sensitivity of 98% and specificity of 90% for differentiation between patients and controls.ConclusionUltrasound can be considered a complementary test to defecography in investigation of patients with obstructed defecation. Ultrasound can diagnose levator muscle attenuation and avulsion, thickness of IS, ES, PRS, and distensibility of hiatal area.

Highlights

Growing attention of pelvic floor disorders has led to development of new imaging techniques, with increasing importance of ultrasonography
Aim of the work The aim of this study was to highlight the role of threedimensional ultrasound in evaluation of obstructed defecation in females and comparing the findings with defecography. This prospective study was conducted from April 2016 to July 2017. It included 30 females classified into two groups: (1) patients as a case group, aged from to 50 years
This study included 30 female patients classified into 20 female patients with chronic constipation and ten normal nulliparous females as a control group

Summary

Introduction

Growing attention of pelvic floor disorders has led to development of new imaging techniques, with increasing importance of ultrasonography. Growing attention of pelvic floor disorders over the last two decades has led to development of new imaging techniques, with increasing importance of ultrasonography. Transvaginal, and transperineal approaches, using both two-dimensional and threedimensional (3D) imaging, have made an important effect on the evaluation of the functional anatomy of the pelvic floor. Voiding dysfunction and urinary incontinence are commonly related to prolapse of the anterior compartment [2]. Pelvic discomfort, such as feelings of a lump, heaviness, and pelvic pressure, is attributed to all pelvic compartments. It is important to be able to differentiate between different anatomic abnormalities, especially with regards to the surgical intervention needed for treatment of the patient [3]

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