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Session: ePoster Monitor 4-Other Neoplasia and Endoscopy and Pelvic Floor

eP320 - Dynamic Transperineal Ultrasound Diagnoses Female Patients with Obstructed Defecation Syndrome: A Study from China

Sunday, June 2, 2024
11:27 AM – 11:32 AM ET, USA
Location: Baltimore Convention Center, Room 318-320

    ePoster Presenter(s)

  • Yahong Xue, MD (she/her/hers)

    Deputy chief physician
    xueyahong_1983@126.com
    Pelvic Floor Medicine Specialty Committee of World Federation of Chinese Medicine Societies
    Nanjing, Jiangsu, China (People's Republic)

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

Purpose/Background: Pelvic floor ultrasound has certain values in diagnosis of defecation disorders, and has advantages of simple and rapid operation, good tolerance, and no radiation. Dynamic transperineal ultrasound(DTPU) can clearly show the entire pelvic floor anatomy, effectively diagnose anatomical abnormalities and can also provide more information about the anterior and middle pelvis. This study was to analyze the accuracy of DTPU for diagnosis of female patients with obstructed defecation syndrome(ODS) using traditional X-ray defecography(DEP) as the gold standard and to determine the grading of rectocele via DTPU.Methods/Interventions: This retrospective study was conducted at the Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Traditional Chinese Medicine. 107 Chinese women with ODS were required to finish the examinations of DEP and TPUS to evaluate Rectocele(RC), Rectal intussusception (RI), Enterocele(EC), Perineal descent (PD) and Dyssynergia defecation(DD) .The patients’ demographic and symptom data were collected including age, body mass index, parity, delivery mode, course of disease, previous surgical history, previous treatment of constipation, and Cleveland Clinic Constipation score.Results/Outcomes: Agreement between the two diagnostic methods was confirmed using Cohen’s kappa statistics as follows: rectocele (kappa=0.738), rectal intussusception (kappa=0.711), dyssynergic defecation (kappa=0.774), enterocele (kappa=0.847), and perineal descent (kappa=0.625), all of which indicated good agreement between DEP and DTPU. The cutoff values for the diagnosis of moderate and severe rectocele with DTPU were 12.05 mm (AUC: 0.941) and 18.50 mm (AUC: 0.977).Conclusion/

Discussion: DTPU has shown high sensitivity and specificity in the diagnosis of RC, RI, EC and DD, and can be used as the first choice of imaging examination for ODS patients. When DTPU finds significant abnormalities, no additional imaging is required unless surgical intervention is considered, which may reduce medical costs and avoid unnecessary radiation."Figure 1 A rectocele (RC) on DEP(a) and DTPU(b)

Figure 2 Consistency analysis of diagnostic results between DEP and DTPU

Figure 3 ROC curve for mild(a) and severe(b) rectocele diagnosed via DTPU

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