Does defecography help in diagnosis and clinical decision-making in defecation disorders?

Defecography is used to investigate patients with defecation disorders, especially obstructed defecation and anal incontinence. We studied 73 consecutive patients who complained of difficult defecation, anal incontinence, or idiopathic anorectal pain. The following defecographic parameters were recorded and compared in different patient groups: anorectal angulation, pelvic floor descent, formation of rectocele, and rectal invagination. Increasing number of childbirths correlated with pelvic floor descent in defecograms (r = 0.319, p < 0.05). There were no significant differences in defecographic parameters in patients with obstructed defecation, anal incontinence, or idiopathic anorectal pain. Thus, we conclude that defecography may be useful as an investigative tool in clinical research of defecation disorders, but it is of minor value in clinical diagnosis and decision-making.