MR-defecography in obstructed defecation: a simplified technique and classification system

ABSTRACT. MR defecography has been proven an excellent imaging modality for the assessment of evacuation dysfunctions. In our institution MRI-defecography is performed with a standard imaging protocol consisting of static axial, coronal and sagittal T2-W fast recovery fast spin-echo (FRFSE) pulse sequence followed by dynamic sagittal T1-W fast spoiled gradient-echo (FSPGR) sequence after rectal contrast administration (US gel mixed with gadopentetate dimeglumine). The high level of agreement between evacuation proctography (EP) and MR-defecography combined with the additional value of axial and coronal scan planes suggests the latter as the method of choice for identification and classification of obstructed defecation syndrome (ODS)

Consensus Statement of the Italian Society of Colorectal Surgery (SICCR): management and treatment of complete rectal prolapse

Rectal prolapse, rectal procidentia, “complete” prolapse or “third-degree” prolapse is the full-thickness prolapse of the rectal wall through the anal canal and has a significant impact on quality of life. The incidence of rectal prolapse has been estimated to be approximately 2.5 per 100,000 inhabitants with a clear predominance among elderly women. The aim of this consensus statement was to provide evidence-based data to allow an individualized and appropriate management and treatment of complete rectal prolapse. The strategy used to search for evidence was based on application of electronic sources such as MEDLINE, PubMed, Cochrane Review Library, CINAHL and EMBASE. The recommendations were defined and graded based on the current levels of evidence and in accordance with the criteria adopted by the American College of Gastroenterology’s Chronic Constipation Task Force. Five evidence levels were defined. The recommendations were graded A, B, and C