Examination of the Anorectal Angle and Pubococcygeal Line in Adults with Anal Disorders and Defecation Irregularities Using Magnetic Resonance Imaging   
Yazarlar (3)
Sedanur Elmalı Kıraç
Tokat Gaziosmanpaşa Üniversitesi, Türkiye
Prof. Dr. Hilal IRMAK SAPMAZ Tokat Gaziosmanpaşa Üniversitesi, Türkiye
Sevgi Yılmaz Sağlam
T.C. Sağlık Bakanlığı, Türkiye
Makale Türü Açık Erişim Özgün Makale
Makale Alt Türü ESCI dergilerinde yayınlanan tam makale
Dergi Adı Journal of clinical practice and research
Dergi ISSN 2980-2156 Wos Dergi
Dergi Tarandığı Indeksler ESCI
Makale Dili İngilizce
Basım Tarihi 05-2024
Cilt No 46
Sayı 3
Sayfalar 224 / 233
DOI Numarası 10.14744/cpr.2024.57286
Makale Linki https://jcpres.com/storage/upload/pdfs/1718031462-en.pdf
Özet
Objective: This study explores the role of pelvic floor (PF) muscles in individuals with anal area diseases and defecation irregularities. Materials and Methods: Anorectal angle (ARA), pubococcygeal line (PCL), and the distance between ARA and PCL were measured retrospectively in 392 images from patients over 18 years old who underwent lower abdomen magnetic resonance (MR) defecography (sagittal, T2 sequence). The patients presented with complaints of fecal incontinence, chronic constipation, anal fissures, hemorrhoids, anal abscesses, and anal or perianal fistulas. Measurements were taken during three phases: rest, Valsalva maneuver, and the final phase of defecation. Patients were categorized according to the World Health Organization’s age classification, and average ages for childbirth and menopause were determined using data from the Turkish Statistical Institute. Results: Across all patients, the ARA did not sufficiently constrict during Valsalva, and was wider in women during all defecation phases. The ARA was wider at rest in patients aged 65 and over, and during the final defecation phase in the 45–64 age group compared to other age groups. Throughout all phases of defecation, the PCL was longer in women and in the 45–64 age group than in others; PF descent during Valsalva and the final phase was greater in these groups as well. Conclusion: The findings highlight that PF insufficiency is more pronounced in the postmenopausal period. Evaluation of the PF should be integrated into the diagnostic and treatment protocols for anal area diseases, with an emphasis on PF rehabilitation.
Anahtar Kelimeler
Constipation | fecal incontinence | anal disorders | pelvic floor | anal canal | rectum