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Gastroenterology Research and Practice
Volume 2017 (2017), Article ID 4392918, 8 pages
https://doi.org/10.1155/2017/4392918
Clinical Study

Postoperative MR Defecography following Failed STARR Procedure for Obstructive Defecation Syndrome: A Three-Centre Experience

1Radiologist Diagnostic Imaging Centre, Iniziativa Medica, Monselice, Padua, Italy
2Technician Diagnostic Imaging Centre, Villa Igea Clinic, Ancona, Italy
3Technician Diagnostic Imaging Centre, Iniziativa Medica, Monselice, Padua, Italy
4Technician Diagnostic Imaging Centre, Studio Ronconi, Acilia, Rome, Italy

Correspondence should be addressed to Vittorio Piloni; ti.orebil@inolip.oirottiv

Received 19 April 2017; Revised 16 July 2017; Accepted 30 August 2017; Published 3 October 2017

Academic Editor: Fernando de la Portilla

Copyright © 2017 Vittorio Piloni et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Aim. To describe the abnormalities at MR imaging and related complaints in patients with poor outcome after STARR procedure. Materials and Methods. The medical records of 21 symptomatic patients from centre 1, 31 patients from centre 2, and 63 patients from centre 3 were reviewed with regard to findings at MR defecography and related symptoms. Results. Regardless of the centre, most relevant imaging features and related complaints were (a) impaired emptying (82.11%), related complaint ODS; (b) persistent rectocele >2 cm and intussusception (39.3%), split evacuation and digitation; (c) pelvic organ descent on straining (39.8%), prolapse sensation; (d) small neorectum and loss of contrast (32.5%), urgency and incontinence; (e) anastomotic stricture and granuloma (28.4%), pain; and (f) nonrelaxing puborectalis muscle (19.5%), tenesmus. Less frequent findings included rectal pocket formation (5.6%) and rectovaginal sinus tract (1.6%). Patients were referred to MR imaging with an average time interval of 5 ± 2, 4 ± 1, and 2 ± 1 years in the three centres, respectively, and only rarely by the same surgeon who performed the operation: 1/21 (4.8%) in centre 1, 3/39 (7.7%) in centre 2, and 9/63 (14.3%) in centre 3. Conclusion. Most surgeons involved in STARR operation with subsequent poor outcome do not rely on MR imaging.