The Efficacy of Dynamic Colpocystodefecography in Pelvic Organ Prolapse

Kim, Jae Heon; Kim, Young Ho; Park, Seong Jin

Abstract

PURPOSE: To evaluate the efficacy of dynamic colpocystodefecography in patients with a pelvic organ prolapse.
MATERIALS AND METHODS
A total of 63 patients, with or without stress urinary incontinence and pelvic organ prolapse, who visited our hospital between April 2002 and July 2003, were studied. All patients were available for physical examination and dynamic colpocystodefecography. The patient was seated on a radiolucent commode, which was upright on the end of a vertically oriented x-ray table. Deliberate efforts were made to ensure privacy. Fluoroscopic images were taken during resting, squeezing, Valsalva effort, voiding and defecation.
RESULTS
On physical examination, cystocele, rectocele and rectal intussusception were revealed in 26 (36%), 20 (31%) and 7 cases (11%), respectively. On dynamic colpocystodefecography, cystocele, rectocele and rectal intussusception were revealed in 44 (69%), 32 (50%) and 15 cases (24%), respectively. Compared with the physical examination, 18 cases of cystocele, 12 of rectocele and 8 of rectal intussusception were newly found through dynamic colpocystodefecography. Enterocele and sigmoidocele were not found in the physical examination, but only found through dynamic colpocystodefecography in 4 and 5 cases, respectively. The degree of prolapse was more severe during defecation than voiding.
CONCLUSIONS
Not all the pelvic organ prolapses were detected on physical examination. Radiological evaluation is necessary for a more accurate detection of a pelvic organ prolapse. Dynamic colpocystodefecography has the advantages of it's ability to be performed for physiological defecation and voiding status, as well as imaging of dynamic pelvic organ structures.