Jamet F, Hoffet M, Courtieu C, Mares P
Service de Gynécologie-Obstétrique, CHU, Nîmes.
J Gynecol Obstet Biol Reprod (Paris). 1999 Feb;28(1):17-23.
To determine the interest of defecography for the initial evaluation of genital prolapses.
A retrospective study of 125 patients who had undergone systematically a defecography for the initial evaluation of a genital prolapse.
10% of defecogaphies were normal. On clinical examination a rectocele was found in 94% of patients and an enterocele in 33%. At defecography, these abnormalities were seen only in 39% and 15% respectively. 39% of patients with radiological rectocele had an intussusception at defecography.
Defecography is appropriate to diagnose and to assess constitutional abnormalities associated with genital prolapse (rectocele, enterocele) and other anomalies which interact with it (intussusception, sphincter and pubo-rectal dyskinesia). Most of women with genital prolapse showed abnormal defecograms. We observed a marked discordance between clinical and radiological evaluation, specially for rectocele. Defecography is of great interest in the evaluation of posterior genital prolapses, specially in women complaining of dyschesia. Defecography may be proposed in case of: posterior vaginal wall prolapse (rectocele, enterocele), dyschesia, post-operative prolapse and before a cervicopexy.
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