Five-Month Follow-Up Assessing Defecography and Urodynamics after Laparoscopic Nerve-Sparing Colorectal Resection for Endometriosis
Sagittal dynamic magnetic resonance defecography: (a) assessment with Fast Imaging Employing Steady-State Acquisition (FIESTA) technique performed prior to surgery exhibiting paradoxical contraction of the puborectalis muscle during simulated defecation straining (anismus), a defecation anorectal angle of 63° (exerting stenosis); (b) assessment with single-shot fast spin echo sequence performed 3 months after nerve-sparing segmental colorectal resection identifying anismus, with a smaller reduction of the defecation anorectal angle of 87° and easier elimination of the rectal gel. Anorectal angle during defecation is normal when higher than at rest. The definitions and boundaries are according to Brandão and Ianez . Panoramic laparoscopic view: (c) in the beginning of the surgery presenting intestinal endometriotic nodule adhered to the left uterine annex (dashed green circle); (d) after segmental colorectal resection with the rectosigmoid in anatomical position.