IS DIGITATION ASSOCIATED WITH PROCTOGRAPHIC ABNORMALITY

Constipated patients referred for evacuation proctography were questio ned as to the need for digital manoeuvres to assist evacuation, to det ermine the frequency of digitation, and to investigate whether any pro ctographic feature was associated with this symptom. Seventy one perce nt of patients interviewed admitted to digitation. Proctographic findi ngs in 20 constipated patients who digitated per vagina and 20 who dig itated per anum were compared to 20 who did not. There was no signific ant difference between groups with respect to pelvic floor descent, an al canal width or any anrectal angle measurement. Rectocoele depth and area were significantly greater in patients who digitated per vagina, compared to the other two groups. Evacuation time was prolonged and a proctographic diagnosis of anismus more frequent, in patients who dig itated per anum, Anal digitation is associated with prolonged evacuati on, suggesting a proctographic diagnosis of anismus and vaginal digita tion to assist rectal evacuation is significantly associated with larg e anterior rectocoele.