CC BY-NC-ND 4.0 · Indographics 2022; 01(01): 016-026
DOI: 10.1055/s-0042-1742576
Review Article

Magnetic Resonance Defecography in Obstructive Defecation Syndrome: A Pictorial Review Imaging Findings and Impact on Surgical Management

Seema Sud
1   Department of CT & MRI, Sir Ganga Ram Hospital
,
Rishabh Khurana
2   Post DM Senior Resident, VMMC and Safdarjung Hospital, New Delhi
,
Brij B. Agarwal
3   Department of Laparoscopic and General Surgery, Sir Gangaram Hospital & GRIPMER, New Delhi
,
Tarvinder B.S. Buxi
1   Department of CT & MRI, Sir Ganga Ram Hospital
,
Samarjit S. Ghuman
1   Department of CT & MRI, Sir Ganga Ram Hospital
› Author Affiliations

Abstract

Pelvic floor, a funnel-shaped muscular structure plays a significant role in bowel and bladder activities. Defecatory disorders result from the structural changes and functional disorders. Pelvic floor dysfunction affects 15% of multiparous women. It is being expected that after 30 years, there would be 45% rise in demand of pelvic floor imaging. After ruling out primary and secondary causes of constipation, diagnosis of obstructed defecation syndrome (ODS) is made. ODS is emerging as one of the important causes of constipation. As the symptoms are nonspecific and examination findings are frequently inaccurate, the clinical evaluation becomes a difficult task. Hence, various imaging modalities are becoming popular as an adjunct tool for the assessment of these disorders. Clinical management of ODS is based on the Constipation and Bowel Activity Score (CABA) and delineation of the pelvic floor anatomy. After defining the pelvic floor anatomy–based structural abnormality, day care ambulatory surgical procedure, that is, stapled transanal resection rectopexy (STARR), is offered to the patients of ODS. It provides significant relief to patients suffering from constipation and reduction in postoperative CABA score. This review discusses the role of magnetic resonance defecography imaging in ODS its impact on subsequent management.



Publication History

Article published online:
19 September 2023

© 2022. Indographics. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 
  • References

  • 1 Agarwal BB, Chintamani C, Mahajan K. Pelvic floor dysfunction: reinventing the spokes of the wheel. JIMSA 2012; 25: 13
  • 2 Agarwal BB, Chintamani C, Mahajan K. Derriere distress-defecation-defication. JIMSA 2013; 26: 155
  • 3 Sharma S, Agarwal B. Scoring system in evaluation of constipation and ODS. JIMSA 2012; 25: 57-59
  • 4 National Institute for Clinical Excellence.. Interventional Procedures Programme: interventional procedures overview of double stapled transanal rectal resection procedure for obstructed defaecation syndrome. Accessed January 11, 2021 at: https://www.nice.org.uk/guidance/ipg351/evidence/overview-315775549
  • 5 Dindo D, Weishaupt D, Lehmann K, Hetzer FH, Clavien PA, Hahnloser D. Clinical and morphologic correlation after stapled transanal rectal resection for obstructed defecation syndrome. Dis Colon Rectum 2008; 51 (12) 1768-1774
  • 6 Agarwal BB, Manish K, Pandey H, Doda R, Agarwal V, Saxena KK. Stapled transanal rectal resection (STARR): results of the first Asian experience. The Gangaram Journal. 2011; 1: 118-122
  • 7 Kelvin FM, Maglinte DD, Hale DS, Benson JT. Female pelvic organ prolapse: a comparison of triphasic dynamic MR imaging and triphasic fluoroscopic cystocolpoproctography. AJR Am J Roentgenol 2000; 174 (01) 81-88
  • 8 Colaiacomo MC, Masselli G, Polettini E. et al. Dynamic MR imaging of the pelvic floor: a pictorial review. Radiographics 2009; 29 (03) e35
  • 9 Thapar RB, Patankar RV, Kamat RD, Thapar RR, Chemburkar V. MR defecography for obstructed defecation syndrome. Indian J Radiol Imaging 2015; 25 (01) 25-30