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Defecography alone provides only a visual
record of events taking place during rectal evacuation.
-
Further
understanding of the pathophysiology of defecation also requires
manometric and electromyographic data from these patients.
-
Performing
detailed radiographic measurements has little clinical significance
because there is such a wide range of normal values. Also, there is high
inter- and intra-observer inconsistency in the measurements.
-
To further
confound things, many of the the seemingly important findings identified
in symptomatic patients may also be seen in normal subjects.
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Thus, defecographic measurements and observations should be interpreted with
caution and should not be used as the only criteria for treatment. Several
recent reports have indicated that the results of defecography did not
alter selection of medical or surgical therapy, and had little impact on
patient response to therapy.
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There is fragmentation of the patient care of
pelvic floor disorders among gynecologists, urologists, and colorectal
surgeons. An interdisciplinary approach involving these
specialists, gastroenterologists, neurologists, and radiologists should
greatly increase our understanding and ability to manage pelvic floor
problems.
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