Coloproctologic disorders of the pelvic floor

Purpose. The aim of this review is to describe the most frequent and import ant coloproctologic pelvic floor disorders. Relevant diagnostic procedures of the pelvic floor will be presented. Material and methods. A host of diagnoses and symptoms such as the descendi ng perineum syndrome, rectocele, cystocele, enterocele, uterine and vaginal descensus,anal and rectal prolaps, outlet obstruction, anismus, inertia re cti and intussusception are included under the heading "pelvic floor disord ers". Although symptoms are often varied, problems concerning urinary and/o r faecal continence commonly lead to primary consultation of a physician. Results. Quite often, apparently divergent symptoms such as constipation an d incontinence are simultaneously mentioned. A clear gender disposition is observed with female patients inflicted nine-fold in comparison to male pat ients. The primary consultant may belong to a variety of specialities such as urology, proctology, gynaecology or dermatology, depending upon the pred ominant symptom. A feeling of trust is essential for the treatment of a dis order involving highly intimate regions of the body. Discussion. An exact medical history and standardized proctologic evaluatio n consisting of inspection, palpation, rectoscopy and proctoscopy may be au gmented by investigations such as anorectal manometry or endosonography. Co nventional defecography has been replaced more and more by dynamic MRI of t he pelvic floor in specialized institutions, enabling additional gynaecolog ic and urologic investigations avoiding ionizing radiation.