COLPOCYSTODEFECOGRAPHY

PURPOSE: To assess, in one single procedure, a complete study of the f emale pelvis, including the Douglas pouch. METHODS: Colpocystodefecogr aphy (CCD) combines vaginal opacification, voiding cystography, and de fecography. Three hundred examinations are reviewed. RESULTS: Thanks t o the simultaneous visualization of the pelvic structures, CCD proved to be more useful than clinical evaluation to diagnose prolapses and p articularly Douglas pouch hernias (enteroceles), the clinical diagnosi s of which was missed in 93 of 111 cases. Moreover, in addition to mor phologic and functional information, CCD brings about a new insight in the study of pelvic organs reciprocal influences, should they be posi tive (supporting function) or negative (external compression). Finally , significative pelvic surgery and particularly hysterectomy enhances greatly the risk of enteroceles. CONCLUSION: CCD is helpful in the pre operative staging, especially in the selection of the surgical procedu re that will least likely predispose to possible late postoperative co mplications such as vaginal prolapses or enteroceles.