Background: Although defecography has been regarded as useful diagnostic tool for patents with defecation disorder, its interpretation goes with much controversy because of the lack of standard normal finding. This study was designed to define the state of normality and to interpret abnormalities more accurately upon it.
Methods: 18 male and 24 female asymptomatic volunteers of young age were introduced and underwent defecographic examinations.
Results: The mean anorectal angles(。) of male subjects were 99.1±14.7, 70.8±14.0 and 112.8±17.4, and those of female subjects were 89.7±13.9, 67.4±12.1 and 111.8±16.8 in order of rest, squeeze and push. The mean anal canal length(cm) of males were 2.2± 0.9, 3.0±0.7 and those of and those of females were 1.9±0.7, 2.1±1.0 in order of rest and squeeze. The mean pelvic descent(cm) of males were 4.3±1.3, 6.2±1.8, and those of females were 4.6±1.4, 7.6±1.6 in order of rest and push. The mean anterior bulging(cm) of females was 3.4±1.4. Rectoceles were shown in 20.8% of female subjects, rectalintus susceptions were in 28.4% and sigmoidoceles in 9.5% of total subjects. The ratio of rest,/push in anorectal angle was more than 0.9 in 21.4% of total subjects. Insufficient opening of anal canal was shown in 31.1% and insufficient rectal emptying was in 35.6% of total subjects.
Conclusion: The representative values of anorectal angle in order of rest, squeeze, push could be 99, 71, 113。 in male asymtomatic subjects and 90, 67, 112。 in female asymtomatic subjects, and those of anal canal length in order of rest, squeeze were 2.2, 3.0 in males, 1.9, 2.1 cm in females, but these values shouldn’t be regarded as normal values because of their wide variation. Upper limits of Pelvic descent in order of rest, push were 5, 8cm in males, 6, 10cm in females respectively. That of anterior bulging in females was 5cm. These values can be rewarded as upper extreme of normal range, but they also lack evidence of symtomatic correlations. Structural deviations such as rectocele, rectal intussusception and sigmoidocele were found in significant numbers of subjects. Functional measurements such as opening of anal canal, decrees of rectal emptying were also abnormal in no less subjects than structural deviations. All the results exhibit that defecographic decision making need extreme caution.
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