de la Portilla Fernando, Rubio Manzanares Dorado Mercedes, Pino Díaz Verónica, Vazquez Monchul Jorge M, Palacios Carmen, Díaz Pavón José M, Sánchez Gil José M, García Cabrera Ana María
Unidad de Gestión Clínica de Cirugía General y del Aparato Digestivo, Hospital Universitario Virgen del Rocío IBiS/CSIC/Universidad de Sevilla, Sevilla, España.
Unidad de Gestión Clínica de Cirugía General y del Aparato Digestivo, Hospital Universitario Virgen del Rocío IBiS/CSIC/Universidad de Sevilla, Sevilla, España.
Cir Esp. 2015 Oct;93(8):530-5. doi: 10.1016/j.ciresp.2014.11.005. Epub 2015 Feb 7.
Dynamic endoanal ultrasound has emerged in recent years as a test that could replace the now existing tests in the diagnosis of pelvic floor disorders. The aim of this paper is to determine the usefulness of echodefecography in the diagnosis and evaluation of patients with symptoms of anorrectal obstruction, and show the results obtained after its implementation in a pelvic floor unit, as a complementary tool that could replace conventional defecography.
In this retrospective study we analyzed 66 patients with a mean age of 55 years (19-83), 61 women (92%). All dynamic ultrasound was performed in 3 dimensions and was correlated with symptoms and physical findings in the consultation. A descriptive and inferential study was performed to find a kappa correlation between physical examination and echodefecography.
The reasons for consultation were: Anorrectal obstruction syndrome 36 patients (54.5%), pelvic organ prolapse 27 patients (40.9%), and anorrectal obstruction syndrome along with pelvic organ prolapse 3 patients (4.5%). The correlation of the 2 groups indicated that echodefecography diagnosed more patients with grade III rectocele, enteroceles, and anismus than the combination of scan-ultrasound-manometry-proctoscopy (Kappa 0.26, 0.38 and 0.21, 95% CI: from 0,07 to 1.00, 0.15 to 1.00 and from 0.12 to 1.00, respectively) (P<.001). Conversely, echodefecography diagnosed less perineal descense (Kappa 0.28, 95% CI: 0.12 to 1.00).
Dynamic anal ultrasonography may have a role as a complementary test in patients with pelvic floor disorders, achieving diagnoses that would go undetected by inspection, physical examination and manometry.
