Consensus Definitions and Interpretation Templates for Fluoroscopic Imaging of Defecatory Pelvic Floor Disorders

Fluoroscopic defecography (FD) is a critical tool long used in the evaluation of defecatory disorders. Like most imaging studies, such examinations are ordered by multiple different specialties, each with its own needs from the examination and different means of interpretation.  

Of note, this is not meant to be an exhaustive description or pictorial essay of all disease processes found on FD. Rather, this is an effort to identify areas of consensus across disciplines so that a common language can be utilized to achieve the shared goal of caring for patients with defecatory pelvic floor disorders. 

A note from the authors: 

“The Pelvic Floor Disorders Consortium (PFDC) is a multidisciplinary organization of colorectal surgeons, urogynecologists, urologists, gynecologists, gastroenterologists, radiologists, physiotherapists, and other advanced care practitioners. Because all these specialists are dedicated to the care of patients with pelvic floor disorders, but sometimes approach evaluation and treatment of patients with pelvic floor complaints with differing perspectives, the PFDC was formed to arrange collaboration between these specialties. 

The PFDC’s goal is to collaborate to develop and evaluate educational programs, create clinical guidelines and algorithms, and promote overall quality of care in this unique population. The following recommendations arising from this effort represent the work product of the PFDC Working Group on Fluoroscopic Imaging of Pelvic Floor Disorders. 

The objective was to generate inclusive, rather than prescriptive, guidance for all practitioners, irrespective of discipline, in the care and treatment of patients with pelvic floor disorders. This process was intended to clarify which domains of fluoroscopic defecography have consensus among multidisciplinary experts, and which areas deserve further dedicated research.”