Conventional assessment of anorectal function with defecating videoproctography is semiquantitative and the high radiation exposure precludes prolonged or repeated testing. The aim of this study was to develop a dynamic scintigraphic method of assessing anorectal function.METHODS:
Fourteen patients with fecal incontinence, 18 patients with chronic constipation, and 8 control subjects were assessed by scintigraphic defecography. This involves introduction of a technetium-99mradiolabeled artificial stool into the rectum of the subject and acquisition of gamma camera images during evacuation.RESULTS:
Mean evacuation rate was 2.8 percent/ second in incontinent patients and 0.9 percent/second in constipated patients (P<0.001). The mean anorectal angles were 136° and 133°, respectively. There were 18 cases of pelvic floor descent and 6 rectoceles. Scintigraphic defecography provides quantitative information on rectal evacuation. Anorectal angle and pelvic floor movement can be examined. The radiation dose to pelvic organs is significantly less than with videoproctography.CONCLUSION:
We believe that scintigraphic defecography is the investigation of choice for objective and dynamic assessment of anorectal function.