New three-dimensional endoanal and endorectal ultrasonographic and magnetic resonance imaging techniques have given better insight into the complex anatomy of the pelvic floor and its pathologic modification in benign anorectal diseases. Obstetrical events leading to fecal incontinence in females, the relationship between fistulous tracks and the sphincter complex, and mechanisms of obstructed defecation syndrome can now be accurately evaluated, which is of fundamental importance for decision making. Thanks to improvements in the diagnosis of these disorders, new forms of treatment have been developed with better outcome for patients. This book is aimed at general and colorectal surgeons, radiologists, gastroenterologists and gynecologists with a special interest in this field. It is also relevant to everyone who wants to improve their understanding of the fundamental principles of pelvic floor disorders.
Foreword by G.G.Delaini Section 1 Fundamental Principles of Ultrasonography.- Section 2 New Technical Developments in Endoanal and Endorectal Ultrasonography .- Section 3 State of the Art in Pelvic Floor Imaging: Endosonographic Anatomy of the Normal Anal Canal. Endosonographic Anatomy of the Rectum. MR Anatomy of the Rectum. Pelvic Floor Imaging.- Section 4 Endoanal Ultrasonography in the Assessment of Patients with Fecal Incontinence: Introduction. Accuracy and Reliability of Endoanal Ultrasonography in the Evaluation of Anal Sphincter Injury. Update in Perineal Anatomy and its relevance to Obstetric Trauma. Fecal Incontinence: Endoanal Ultrasonography versus Endoanal MR imaging.- Section 5 Endoanal Ultrasonography in the Evaluation of Perianal Sepsis and Fistula in Ano: Introduction. Accuracy and Reliability of Endoanal Ultrasonography in the Evaluation of Perirectal Abscesses and anal Fistula. Fistula-in-ano: Endoanal Ultrasonography versus Endoanal MR Imaging.- Section 6 Update in the Evaluation of Outlet Obstruction: Introduction. Accuracy and Reliability of Endoanal Ultrasonography in the Evaluation of outlet Obstruction. Transperineal Dynamic Ultrasonography. Defecographic Study of Rectal Evacuation in Constipated Patients. Dynamic MR imaging of Pelvic Organ Prolapse.- Section 7 Anorectal Physiology Testing: Manometric and Myographic Evaluation of the Anal sphincters Morphology and Function. What studies do we really need in the Treatment of Benign Anorectal Diseases.- Section 8 Treatment Options for Fecal Incontinence: Introduction. Surgical Treatment of Fecal Incontinence. Neuromodulation for Fecal Incontinence. New Treatment Options for Fecal Incontinence. Incontinence: biofeedback and other non-operative Modalities.- Section 9 Treatment Options for Anal Fistulae.- Section 10 Current Concepts in Management of Outlet Obstruction