| Dynamic anal endosonography may challenge defecography for assessing dynamic anorectal disorders: results of a prospective pilot study. | |
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MedLine Citation:
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PMID: 10774969 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND STUDY AIMS: The diagnosis of anorectal dynamic disorders and perineal insufficiency has been mainly based up to now on the use of defecography. Here, we performed a prospective blinded study to evaluate the accuracy of a new procedure, dynamic anorectal endosonography (DAE), by comparing it with defecography. PATIENTS AND METHODS: A total of 43 women (mean age 53), presenting with outlet obstruction, were prospectively enrolled in our study. The DAE was performed with a 7.5-Mhz linear probe (Toshiba, Tokyo, Japan) with basal and straining recordings. None of the DAE or defecography operators was informed about the results of the respective other investigation. RESULTS: Defecography showed a descending perineum in 29 patients (68%), a rectocele in 25 patients (58%), and a rectal intussusception in eight patients (18%). The rate of concordance between the diagnosis of descending urinary bladder at DAE and descending perineum at defecography was 35/43 (80%), and that between the descending puborectal muscle at DAE and descending perineum at defecography was 40/43 (93 %). The rates of concordance between DAE and defecography for the diagnosis of rectocele and rectal intussusception were 27/43 patients (57%) and 34/43 patients (80%), respectively. In the last 15 patients, the DAE technique was adapted in order to improve the accuracy for diagnosing rectocele by filling the rectum with water. This improved sensitivity from 36 to 86% and accuracy from 57 to 87%. CONCLUSIONS: DAE is a new imaging approach to anorectal dynamic disorders, providing a highly reliable means of diagnosing perineal insufficiency as well as rectocele. DAE should be substituted for previous methods since it makes it possible at the same time to assess the anal sphincters and to avoid pelvic irradiation. |
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Authors:
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M Barthet; F Portier; L Heyries; P Orsoni; M Bouvier; D Houtin; N Barriere; P Mambrini; J Salducci; J C Grimaud |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article |
Journal Detail:
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Title: Endoscopy Volume: 32 ISSN: 0013-726X ISO Abbreviation: Endoscopy Publication Date: 2000 Apr |
Date Detail:
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Created Date: 2000-06-20 Completed Date: 2000-06-20 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0215166 Medline TA: Endoscopy Country: GERMANY |
Other Details:
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Languages: eng Pagination: 300-5 Citation Subset: IM |
Affiliation:
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INSERM U315, Marseille, France. mbarthet@mail.ap-hm.fr |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Anus Diseases / diagnosis*, physiopathology Defecation Defecography Endosonography / methods* Female Humans Middle Aged Pilot Projects Predictive Value of Tests Prospective Studies Rectal Diseases / diagnosis*, physiopathology Sensitivity and Specificity |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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