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Objective The imaging findings of X-ray defecography(XRD)and magnetic resonance defecog-raphy(MRD)of patients with Solitary Rectal Ulcer syndrome(SRUS)were retrospectively analyzed to provide important information for clinical diagnosis and treatment.Methods 19 patients with SRUS confirmed by clinical,pathological and colonoscopy were included in this study.Among them,15 patients underwent XRD and 7 patients underwent MRD,and 3 patients underwent both XRD and MRD.Data of all enrolled patients were collected and pelvic floor function was measured.Results In the results of XRD,3 patients(20%)showed rectal intussusception.8 patients(53.3%)showed external rectal prolapse and 2 patients(13.3%)showed moderate rectocele.In addition,there were 2 patients of puborectal muscle hypertrophy,and 1 patient of bladder prolapse and uterine prolapse,respectively.For MRD,3 patients(42.9%)showed rectal mucosal prolapse(partial prolapse).At 4 patients(57.1%)with rectocele,3 patients(all female)had moderate rectocele,1 patient had mild rectocele.3 patients were also observed related anterior and middle compartment organ descent.2 patients of pubulorectal muscle hypertrophy,no sigmoidocoele.Conclusion Defecography can evaluate the structural and functional abnormalities of pelvic floor in SRUS patients,such as external rectal prolapse,rectal protrusion,rectal mucosal prolapse,and rectal intussusception,which has guiding significance for the treatment of SRUS patients.
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Background: Functional disorders of the pelvic ?oor are a common clinical problem. Diagnosis and treatment of these disorders, which frequently manifest with nonspeci?c symptoms such as constipation or incontinence, remain dif?cult. MR Defecography has emerged over the last decade as a modality which additionally images the pelvic floor function in real time besides combining the advantages of previously used modalities and that of magnetic resonance i.e. multiplanar imaging, good temporal resolution and lack of radiation exposure. Dynamic MRI defecography is a relatively new imaging protocol which can be extremely useful in identification of anatomic and functional pelvic floor dysfunction such as organ prolapse, anismus and fecal incontinence. Excellent demonstration of the perirectal soft tissues allows assessment of spastic pelvic ?oor syndrome and descending perineum syndrome and visualization of enteroceles. The aim of the study was to assess causes of pelvic floor dysfunction.Methods: Authors evaluated 25 patients with cine Magnetic Resonance Defecography at our center between December 2018 and 15th May 2019. MR Defecography was done with help of 3 Tesla Somatom Seimens MRI. Ultrasound jelly was instilled into the rectum of patient via a short flexible tube while the patient lies in the lateral decubitus position on the scanner table before being moved into the gantry and was asked to defecate when instructed. Scanning was done in four phases-resting, straining, squeezing and defecation as per the standard protocol while patient lied supine.Results: Most common complaint encountered was that of constipation. Patients in age group 20-70 years were studied. Maximum patient were of the age group 40-50 years. Most common finding was organ prolapse in total 9 patients with anterior rectocele in 6 patients followed by rectal prolapse.Conclusions: Magnetic resonance defecography is an excellent modality for assessment of pelvic floor disorders. It has very good temporal resolution and high soft tissue contrast, also allows visualization of the pelvic floor function in real-time without any radiation load. Imaging the defecation process in real-time leads to a definitive diagnosis in cases of dysfunctional defecation and a precise diagnostic and pre-operative assessment in cases of organ prolapse.