Comparison of three-dimensional pelvic floor ultrasonography and defecography for assessment of posterior pelvic floor disorders.

PURPOSE: The aim of this study was to determine the accuracy and agreement of 3D pelvic floor ultrasonography with defecography in the assessment of posterior pelvic disorders. METHOD: Eligible patients were consecutive women with undergoing 3D pelvic floor ultrasonography between August 2017 and February 2019 at one hospital. All 3D pelvic floor ultrasonography was performed by one examiner. Total 167 patients with suspected posterior pelvic disorders were retrospectively enrolled in the study. The patients were divided into three groups according to their main symptoms. RESULT: There were 82 rectoceles on defecography (55 barium trapping) and 84 on 3D pelvic floor ultrasonography. There were each 6 enteroceles on both modalities. There were 43 patients with pelvic floor dyssynergia on defecography and 41 on ultrasonography. There were 84 patients with intussusception on defecography and 41 on 3D pelvic floor ultrasonography. Agreement of the two diagnostic tests was confirmed using Cohen's kappa value. Rectocele (kappa 0.784) and enterocele (kappa 0.654) indicated good agreement between defecography and 3D pelvic floor ultrasonography. In addition, pelvic floor dyssynergia (kappa 0.406) showed moderate agreement and internal intussusception (kappa 0.296) had a fair agreement. CONCLUSION: This study showed good agreement for the detection of posterior pelvic disorders between defecography and 3D pelvic floor ultrasonography.