Journal Mobile Options
Table of Contents
Vol. 77, No. 4, 2014
Issue release date: June 2014
Gynecol Obstet Invest 2014;77:231-239
(DOI:10.1159/000360135)

Diagnostic Effectiveness of Dynamic Colpocystoproctography in Women Planning for Combined Surgery with Urinary Incontinence and Pelvic Organ Prolapse

Kim J.H. · Park S.J. · Yi B.H. · Lee K.W. · Kim M.E. · Kim Y.H.
aDepartment of Urology, Soonchunhyang University Hospital, College of Medicine, Soonchunhyang University, bDepartment of Diagnostic Radiology, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, Seoul, and Departments of cRadiology and dUrology, Soonchunhyang University Hospital, College of Medicine, Soonchunhyang University, Bucheon, Korea

Individual Users: Register with Karger Login Information

Please create your User ID & Password





Contact Information











I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in

Abstract

Objective: To evaluate the advantage of performing the dynamic cystoproctography (DCP) in patients planning for combined surgery due to urinary incontinence and pelvic organ prolapse (POP). Materials and Methods: We performed DCP on a total of 113 consecutive women with POP and compared the findings of the physical examination with POP quantification against those of DCP including squeezing, straining and evacuation phases, and analyzed the changes to the rates of surgical planning. For statistical analysis, sensitivity, specificity, and positive predictive value of each test were performed. Results: DCP identified an additional 10 cases of cystocele, 32 cases of rectocele, 2 cases of enterocele, 4 cases of sigmoidocele, and 8 cases of rectal intussusception compared to those cases who were only included for a physical examination. The initial surgical plan was changed in a total of 24 cases (22.1%). The prevalence of bowel symptoms in the group in which the surgical plan changed was higher than in the group with no changes to the surgical plan (p = 0.023). Conclusions: DCP may be a more sensitive test for diagnosing POP compared to physical examination alone, and it is useful to patients with bowel symptoms by making surgical planning for combined surgery with stress urinary incontinence and POP. © 2014 S. Karger AG, Basel



Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Kobashi KC, Leach GE: Pelvic prolapse. J Urol 2000;164:1879-1890.
  2. Bump RC, Mattiasson A, Bo K, Brubaker LP, DeLancey JO, Klarskov P, Shull BL, Smith AR: The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 1996;175:10-17.
  3. Heit M, Culligan P, Rosenquist C, Shott S: Is pelvic organ prolapse a cause of pelvic or low back pain? Obstet Gynecol 2002;99:23-28.
  4. Romanzi LJ, Chaikin DC, Blaivas JG: The effect of genital prolapse on voiding. J Urol 1999;161:581-586.
  5. Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL: Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 1997;89:501-506.
  6. Maglinte DD, Bartram CI, Hale DA, Park J, Kohli MD, Robb BW, Romano S, Lappas JC: Functional imaging of the pelvic floor. Radiology 2011;258:23-39.
  7. Gill EJ, Hurt WG: Pathophysiology of pelvic organ prolapse. Obstet Gynecol Clin North Am 1998;25:757-769.
  8. Maglinte DD, Hale DS, Sandrasegaran K: Comparison between dynamic cystocolpoproctography and dynamic pelvic floor MRI: pros and cons. Which is the ‘functional' examination for anorectal and pelvic floor dysfunction? Abdom Imaging 2013;38:952-973.
  9. Brubaker L, Retzky S, Smith C, Saclarides T: Pelvic floor evaluation with dynamic fluoroscopy. Obstet Gynecol 1993;82:863-868.

    External Resources

  10. Halligan S, Spence-Jones C, Kamm MA, Bartram CI: Dynamic cystoproctography and physiological testing in women with urinary stress incontinence and urogenital prolapse. Clin Radiol 1996;51:785-790.
  11. Hock D, Lombard R, Jehaes C, Markiewicz S, Penders L, Fontaine F, Cusumano G, Nelissen G: Colpocystodefecography. Dis Colon Rectum 1993;36:1015-1021.
  12. Hodroff MA, Stolpen AH, Denson MA, Bolinger L, Kreder KJ: Dynamic magnetic resonance imaging of the female pelvis: the relationship with the pelvic organ prolapse quantification staging system. J Urol 2002;167:1353-1355.
  13. Kelvin FM, Maglinte DD: Dynamic cystoproctography of female pelvic floor defects and their interrelationships. AJR Am J Roentgenol 1997;169:769-774.
  14. Kelvin FM, Maglinte DD, Benson JT, Brubaker LP, Smith C: Dynamic cystoproctography: a technique for assessing disorders of the pelvic floor in women. AJR Am J Roentgenol 1994;163:368-370.
  15. Maglinte DD, Kelvin FM, Hale DS, Benson JT: Dynamic cystoproctography: a unifying diagnostic approach to pelvic floor and anorectal dysfunction. AJR Am J Roentgenol 1997;169:759-767.
  16. Barber MD, Brubaker L, Nygaard I, Wheeler TL 2nd, Schaffer J, Chen Z, Spino C: Defining success after surgery for pelvic organ prolapse. Obstet Gynecol 2009;114:600-609.
  17. Maglinte DD, Bartram C: Dynamic imaging of posterior compartment pelvic floor dysfunction by evacuation proctography: techniques, indications, results and limitations. Eur J Radiol 2007;61:454-461.
  18. Kelvin FM, Hale DS, Maglinte DD, Patten BJ, Benson JT: Female pelvic organ prolapse: diagnostic contribution of dynamic cystoproctography and comparison with physical examination. AJR Am J Roentgenol 1999;173:31-37.
  19. Shorvon PJ, McHugh S, Diamant NE, Somers S, Stevenson GW: Defecography in normal volunteers: results and implications. Gut 1989;30:1737-1749.
  20. Siproudhis L, Ropert A, Lucas J, Raoul JL, Heresbach D, Bretagne JF, Gosselin M: Defecatory disorders, anorectal and pelvic floor dysfunction: a polygamy? Radiologic and manometric studies in 41 patients. Int J Colorectal Dis 1992;7:102-107.
  21. Link G, van Dooren IM, Wieringa NM: The extended reconstruction of the pubocervical layer appears superior to the simple plication of the bladder adventitia concerning anterior colporrhaphy: a description of two techniques in an observational retrospective analysis. Gynecol Obstet Invest 2011;72:274-280.
  22. Kim JH, Kim YH, Park SJ: The efficacy of dynamic colpocystodefecography in pelvic organ prolapse. Korean J Urol 2005;46:288-294.
  23. Lee JY, Kim SW, Park WJ, Jung WG, Lee SJ, Jung SE, Cho YH, Yoon MS: Usefulness of dynamic MRI in diagnosis of stress urinary incontinence. Korean J Urol 2001;42:1152-1158.
  24. Lienemann A, Fischer T: Functional imaging of the pelvic floor. Eur J Radiol 2003;47:117-122.
  25. Gordon D, Pearce M, Norton P, Stanton SL: Comparison of ultrasound and lateral chain urethrocystography in the determination of bladder neck descent. Am J Obstet Gynecol 1989;160:182-185.
  26. Yang A, Mostwin JL, Rosenshein NB, Zerhouni EA: Pelvic floor descent in women: dynamic evaluation with fast MRI and cinematic display. Radiology 1991;179:25-33.

    External Resources

  27. Kruyt RH, Delemarre JB, Doornbos J, Vogel HJ: Normal anorectum: dynamic MRI anatomy. Radiology 1991;179:159-163.

    External Resources

  28. Cheng D: Relationship between anorectal pressure and pelvic floor muscle tension in patients with pelvic floor organ prolapse accompanied by outlet obstruction. Gynecol Obstet Invest 2011;72:174-178.
  29. Altringer WE, Saclarides TJ, Dominguez JM, Brubaker LT, Smith CS: Four-contrast defecography: pelvic ‘floor-oscopy'. Dis Colon Rectum 1995;38:695-699.
  30. Vanbeckevoort D, Van Hoe L, Oyen R, Ponette E, De Ridder D, Deprest J: Pelvic floor descent in females: comparative study of colpocystodefecography and dynamic fast MRI. J Magn Reson Imaging 1999;9:373-377.

    External Resources

  31. Kelvin FM, Maglinte DD, Hale DS, Benson JT: Female pelvic organ prolapse: a comparison of triphasic dynamic MRI and triphasic fluoroscopic cystocolpoproctography. AJR Am J Roentgenol 2000;174:81-88.
  32. Pe P: Application of Theory to Surgical Management of Pelvic Floor Disorders. New York, Saunders, 2002.
  33. Bertschinger KM, Hetzer FH, Roos JE, Treiber K, Marincek B, Hilfiker PR: Dynamic MRI of the pelvic floor performed with patient sitting in an open-magnet unit versus with patient supine in a closed-magnet unit. Radiology 2002;223:501-508.
  34. Lamb GM, de Jode MG, Gould SW, Spouse E, Birnie K, Darzi A, Gedroyc WM: Upright dynamic MR defaecating proctography in an open configuration MR system. Br J Radiol 2000;73:152-155.
  35. Roos JE, Weishaupt D, Wildermuth S, Willmann JK, Marincek B, Hilfiker PR: Experience of 4 years with open MR defecography: pictorial review of anorectal anatomy and disease. Radiographics 2002;22:817-832.
  36. Herschorn S, Carr LK: Vaginal reconstructive surgery for sphincteric incontinence and prolpase, ed 8. Philadelphia, Saunders, 2002.
  37. Fletcher JG, Busse RF, Riederer SJ, Hough D, Gluecker T, Harper CM, Bharucha AE: Magnetic resonance imaging of anatomic and dynamic defects of the pelvic floor in defecatory disorders. Am J Gastroenterol 2003;98:399-411.


Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50