Clinical applications and techniques of cinedefecography

Background: Cinedefecography is of value in routine examination of functional disorders of the pelvic floor. Interest in this technique has rapidly expanded owing to the increased availability of colorectal physiologic testing and better understanding of the multifactorial pathophysiology involving evacuation disorders. Methods: A summary of the available techniques, methodology, and indications for cinedefecography was undertaken. In addition, information was provided on interpretation of these images particularly in the context of anatomic abnormalities and clinical applications. Results: Cinedefecography can be rapidly and easily performed using standard radiographic equipment. Effective radiation dose is significantly lower than for other intestinal contrast studies. The technique has been found most useful for measurements of perineal descent, puborectalis length, and ascertaining the function of the puborectalis muscle and pelvic floor. Common diagnoses that can be made by this test include nonrelaxing puborectalis syndrome, perineal descent, rectocele, enterocele, sigmoidocele, and rectoanal intussusception. Conclusion: Cinedefecography provides a wide range of information to assist the surgeon with the evaluation and management of patients with evacuatory and other associated pelvic floor disorders.