Correlation between congenital pelvic floor muscle development assessed by magnetic resonance imaging and postoperative defecation
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In brief
In brief
This study examines 89 male children with congenital anorectal malformation to determine if pelvic floor muscle development visible on MRI correlates with postoperative bowel function. Results show a significant correlation in patients with perineal fistula, where better striated muscle complex scores predicted superior defecation outcomes.
- MRI assessment of striated muscle complex (SMC) correlates with bowel function outcomes in pediatric anorectal malformation patients.
- Perineal fistula patients show best outcomes: 77% have good SMC scores and bowel function scores ≥17 points postoperatively.
- Higher fistula types (rectourethral, rectovesical) demonstrate poorer SMC development and significantly worse defecation outcomes.
- Preoperative MRI evaluation of pelvic floor muscles may help predict postoperative bowel function in congenital anorectal malformations.
- SMC development strongly predicts defecation outcomes in perineal fistula cases but correlation is weaker in higher fistula types.
Written by the GCMD Library team from the article.
Abstract
Objective
Children with congenital anorectal malformation (CAM) experience challenges with defecation. This study aims to assess defecation in preschool-age children with CAM and to evaluate the correlation between pelvic floor muscle developed assessed by magnetic resonance imaging (MRI) and postoperative defecation.
Methods
We collected clinical data and MRI results from 89 male children with CAM. The bowel function scores for children with Perineal (cutaneous) fistula, Rectourethral fistula(Prostatic or Bulbar), and Rectovesical fistula were computed. MRI scans were subjected to image analysis of the striated muscle complex (SMC). The association between pelvic floor muscle score and bowel function score was examined using the Cochran-Armitage Trend Test.
Results
We observed that 77.4% of the SMC scores by MRI for Perineal fistula were good. The Rectourethral fistula SMC score was 40.6% for moderate and 59.4% for poor. The SMC score for Rectovesical fistula was 100% for moderate. Furthermore, 77.4% of patients with Perineal fistula had bowel function scores (BFS) ≥ 17 points. Among those with Rectourethral fistula and Rectovesical fistula, 12.5% and 0 had BFS ≥ 17 points, respectively. An analysis of muscle development and bowel function in patients with Rectovesical fistula, Rectourethral fistula, and Perineal fistula revealed a correlation between SMC development and BFS. Subgroup analysis showed that the Perineal fistula had statistical significance; however, the Rectourethral fistula and Rectovesical fistula were not statistically significant.
Conclusion
A correlation exists between pelvic floor muscle development and postoperative defecation in children with Perineal fistula.