Five-Month Follow-Up Assessing Defecography and Urodynamics after Laparoscopic Nerve-Sparing Colorectal Resection for Endometriosis

Table 2

Bowel assessment.

	Before surgery	3-month follow-up
Rigid rectosigmoidoscopy
Observations	Stenosis 15 cm from the anus	Normal up to 25 cm
Bowel function
Cyclic changes in bowel movement	Tendency to diarrhea	No
Cyclic abdominal distension	Yes	No
Hematochezia	No	No
Feeling of incomplete evacuation (rectal tenesmus)	Sometimes	Milder and less frequent
Need to use of laxative to evacuate	No	No
Frequency	Once every 3 days	Once a day
Time to evacuate (min)	3	2
Anorectal function (DMRD)
Anorectal angle at rest	93	109
Anorectal angle during squeeze (Valsalva)	69	72
Anorectal angle during defecation straining	63	87
Incomplete emptying	Yes	No
Slow emptying	Yes	No
Anismus	Yes	Yes, but less evident

Rigid rectosigmoidoscopy found no inflammatory disease. DMRD: dynamic magnetic resonance defecography. Anismus: paradoxical contraction of the puborectalis muscle during simulated defecation straining (this contraction reduces the anorectal angle, when there should be relaxation that increases the anorectal angle). Anorectal angle at rest: normal when between 70° and 134°. Anorectal angle during squeeze: normal when decreases more than 20°. Anorectal angle during defecation: normal when higher than at rest. The definitions and normal ranges are according to Brandão and Ianez [9].