PELVIC FLOOR DYSFUNCTION IN MALE PATIENTS WITH FISTULA-IN-ANO: AN OBSERVATIONAL STUDY
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Keywords
Perianal fistula, MRI defecography, pelvic floor dysfunction, anorectal angle, dynamic MRI
Abstract
Perianal fistula is a perpetual inflammatory disease that is accompanied by broken communication between the canal and perianal skin. Proper preoperative evaluation is essential to reduce the recurrence and maintain the continence. A clear assessment of fistulous tracts and the pelvic floor structures can be found by MRI. This observational study was an analytical observational one and was performed in Pt. B. D. Sharma PGIMS, Rohtak and involved eighty men patients whose fistula-in-ano was clinically diagnosed. A 3 Tesla MRI scanner was used to assess the imaging of H-line, M-line, anorectal angle, and levator plate angle with the use of both static and dynamic sequences and correlate them to fistula grade, activity, and complexity. Fistulas were categorised with reference to the St. James MRI grading system. Results showed hiatal enlargement in 43.7, pelvic floor descent in 37.5, abnormal anorectal angle and 30 and abnormal levator plate angle and 6.2 respectively. The severity of dysfunction was positively related to better grades, activity, and complexity, which was most likely to be observed in Grade V lesions. The defecation phase dynamic MRI was found to be better in the detection of functional abnormalities. The research confirms that MRI is essential to complete assessment of structural and functional changes in fistula-in-ano that enhances preoperative planning and prognystic evaluation.
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Dr. Vrinda
University-GSVM medical college, Atal Bihari Vajpayee Medical University (UPMCI)