Idowu Esther, Ralston Charlotte, Solanki Deepa, Ferrari Linda, Williams Andrew, Schizas Alexis Mp, Hainsworth Alison J
Guy's & St Thomas' Foundation Trust, London, UK.
Ultrasound. 2025 Jul 8:1742271X251346946. doi: 10.1177/1742271X251346946.
Pelvic floor defaecatory dysfunction is traditionally investigated with defaecatory proctography, which examines rectocele, enterocele, intussusception and functional aspects including dyssynergy and completeness of evacuation. Integrated total pelvic floor ultrasound offers a means to investigate these anatomical features as well as muscle co-ordination and propulsion, without the requirement of rectal contrast expulsion on a commode. We explore patient preference for each procedure.
A prospective study was taken of women who had undergone both defaecatory proctography and total pelvic floor ultrasound for defaecatory dysfunction (incomplete evacuation with or without concomitant faecal incontinence). Patients were given a preference questionnaire after each test, which was subsequently qualitatively analysed.
A total of 247 patients underwent defaecatory proctography and total pelvic floor ultrasound with completed data sets for 224. Total pelvic floor ultrasound was preferred by 123 patients, 86 preferred defaecatory proctography and 15 had no preference. Scores for embarrassment, discomfort and anxiety were less for total pelvic floor ultrasound. There was no significant difference in mean pain scores for either test or in their ability to improve patient understanding of the underlying symptom aetiology. There was no significant difference in embarrassment scores between those with or without seepage of barium paste during defaecatory proctography, nor in cases of poor co-ordination or propulsion in either total pelvic floor ultrasound or defaecatory proctography.
More patients preferred total pelvic floor ultrasound due to less embarrassment, discomfort and the absence of oral contrast or rectal paste. This study offers insights into patient perspectives on pelvic floor investigations, serving as an important starting point for patient-centred clinical decision-making.
传统上采用排粪造影来研究盆底排便功能障碍，该检查可检测直肠膨出、肠膨出、肠套叠以及包括协同失调和排便完整性在内的功能方面。综合性全盆底超声提供了一种研究这些解剖特征以及肌肉协调和推进情况的方法，无需在便桶上排出直肠造影剂。我们探讨患者对每种检查方法的偏好。
对因排便功能障碍（有或无伴随粪便失禁的排便不完整）而接受了排粪造影和全盆底超声检查的女性进行了一项前瞻性研究。在每次检查后，向患者发放一份偏好调查问卷，随后进行定性分析。
共有247例患者接受了排粪造影和全盆底超声检查，其中224例有完整数据集。123例患者更倾向于全盆底超声检查，86例更喜欢排粪造影，15例无偏好。全盆底超声检查在尴尬、不适和焦虑方面的得分更低。两种检查的平均疼痛评分或在改善患者对潜在症状病因理解能力方面均无显著差异。在排粪造影过程中，有或无钡糊渗漏的患者在尴尬评分上无显著差异，在全盆底超声检查或排粪造影中，肌肉协调或推进不佳的情况也是如此。
由于尴尬、不适程度较低且无需口服造影剂或直肠糊剂，更多患者更喜欢全盆底超声检查。本研究为患者对盆底检查的观点提供了见解，是以人为本的临床决策的重要起点。
