Skip to main content

Constipation and Prolapse

  • Chapter
Imaging Pelvic Floor Disorders

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

  • 1523 Accesses

Abstract

Constipation is a symptom that we all have experienced at some time or another. While the vast majority of patients with constipation need no specialist medical investigation, the radiological investigation of severely affected patients has attracted considerable attention over recent years. This has happened in tandem with the parallel development of techniques for physiologic assessment and a greater understanding of the pathophysiology of the condition. Ultimately, despite this wealth of research, the role of imaging remains controversial. This chapter will define the role of evacuation proctography in the investigation of severely constipated patients and will stress the importance of a balanced interpretation that takes account of both structural and functional imaging findings in these individuals.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Similar content being viewed by others

References

  • Alstrup N, Ronholt C, Fu C, Rasmussen O, Sorensen M, Christiansen J (1997) Viscous fluid expulsion in the evaluation of the constipated patient. Dis Colon Rectum 40:580–584

    CAS  PubMed  Google Scholar 

  • Arnold MW, Stewart WR, Aguilar PS (1990) Rectocele repair: 4 years experience. Dis Colon Rectum 33:684–687

    CAS  PubMed  Google Scholar 

  • Bernini A, Madoff RD, Lowry AC, Spencer MP, Gemlo BT, Jensen LL, Wong WD (1998) Should patients with combined colonic inertia and nonrelaxing pelvic floor undergo subtotal colectomy? Dis Colon Rectum 41:1363–1366

    CAS  PubMed  Google Scholar 

  • Bleijenberg G, Kuijpers HC (1987) Treatment of the spastic pelvic floor syndrome with biofeedback. Dis Colon Rectum 30:108–111

    CAS  PubMed  Google Scholar 

  • Bouchard C (1906) Lectures on auto-intoxication in disease or self-poisoning of the individual. Philadelphia: Davis pp. 15

    Google Scholar 

  • Broden B, Snellman B (1968) Procidentia of the rectum studied with cineradiography: a contribution to the discussion of the causative mechanism. Dis Colon Rectum 11:330–347

    CAS  PubMed  Google Scholar 

  • Cavallo G, Salzano A, Grassi R, de Lillo ML (1993) Functional intraperineal pouch of rectal wall (posterior rectocele). Dis Colon Rectum 36:179–181

    CAS  PubMed  Google Scholar 

  • Chaussade S, Khyari A, Roche H et al (1989) Determination of total and segmental colonic transit time in constipated patients: results in 91 patients with a new simplified method. Dig Dis Sci 34:1168–1172

    CAS  PubMed  Google Scholar 

  • Christiansen J, Zhu BW, Rasmussen OO, Sorensen M (1992) Internal rectal intussusception: results of surgical repair. Dis Colon Rectum 35:1026–1029

    CAS  PubMed  Google Scholar 

  • D’Hoore A, Penninckx F (2003) Obstructed defecation. Colorectal Dis 5:280–287

    PubMed  Google Scholar 

  • Drossman DA (1994) Idiopathic constipation: definition, epidemiology and behavioural aspects. In: Kamm M, Lennard-Jones J, eds. Constipation. Petersfield: Wrightson Biomedical p. 11–17

    Google Scholar 

  • Duthie GS, Bartolo DC (1992) Anismus: the cause of constipation? World J Surg 16:831–835

    CAS  PubMed  Google Scholar 

  • Dvorkin LS, Knowles CH, Scott SM, Williams NS, Lunniss PJ (2005a) Rectal intussusception: characterization of symptomatology. Dis Colon Rectum 48:824–831

    PubMed  Google Scholar 

  • Dvorkin LS, Gladman MA, Epstein J, Scott SM, Williams NS, Lunniss PJ (2005b) Rectal intussusception in symptomatic patients is different from that in asymptomatic volunteers. Br J Surg 92:866–872

    CAS  PubMed  Google Scholar 

  • Ebbell BB (1937) The papyrus Ebers. Copenhagen: Levin and Munksgaard p. 30–32

    Google Scholar 

  • Engel AF, Kamm MA (1994) The acute effect of straining on pelvic floor neurological function. Int J Colorect Dis 9:8–12

    CAS  Google Scholar 

  • Eu KW, Seow-Choen F (1997) Functional problems in adult rectal prolapse and controversies in surgical management. Br J Surg 84:904–911

    CAS  PubMed  Google Scholar 

  • Evans RC, Kamm MA, Hinton JM, Lennard-Jones JE (1992) The normal range and a simple diagram for recording whole gut transit time. Int J Colorect Dis 7:15–17

    CAS  Google Scholar 

  • Fleshman JW, Dreznik Z, Cohen E, Fry RD, Kodner IJ (1992) Balloon expulsion test facilitates diagnosis of pelvic floor outlet obstruction due to nonrelaxing puborectalis muscle. Dis Colon Rectum 35:1019–1025

    CAS  PubMed  Google Scholar 

  • Gattuso JM, Kamm MA (1997) Clinical features of idiopathic megarectum and idiopathic megacolon. Gut 41:93–99

    CAS  PubMed  Google Scholar 

  • Gladman MA, Dvorkin LS, Scott SM, Lunniss PJ, Williams NS (2007) A novel technique to identify patients with megarectum. Dis Colon Rectum 50:621–629

    PubMed  Google Scholar 

  • Glia A, Lindberg G (1998) Antroduodenal manometry findings in patients with slow-transit constipation. Scand J Gastroenterol 33:55–62

    CAS  PubMed  Google Scholar 

  • Goh V, Halligan S, Kaplan G, Healy JC, Bartram CI (2000) Dynamic MR imaging of the pelvic floor in asymptomatic subjects. AJR 174:661–666

    CAS  PubMed  Google Scholar 

  • Grassi R, Romano S, Micera O, Fioroni C, Boller B (2005) Radiographic findings of post-operative double stapled trans anal rectal resection (STARR) in patient with obstructed defecation syndrome (ODS). Eur J Radiol 53:410–416

    PubMed  Google Scholar 

  • Greenberg T, Kelvin FM, Maglinte DD (2001) Barium trapping in rectoceles: are we trapped by the wrong definition? Abdom Imaging 26:587–590

    CAS  PubMed  Google Scholar 

  • Halligan S (1994) Posterior perineal hernia or posterior rectocoele? Clin Radiol 49:219

    CAS  PubMed  Google Scholar 

  • Halligan S (1995) The benefits or otherwise of evacuation proctography. Abdom Imaging 20:280

    CAS  PubMed  Google Scholar 

  • Halligan S, McGee S, Bartram CI (1994) Quantification of evacuation proctography. Dis Colon Rectum 37:1151–1154

    CAS  PubMed  Google Scholar 

  • Halligan S, Bartram CI (1995) Is barium trapping in rectocoeles significant? Dis Colon Rectum 38:764–768

    CAS  PubMed  Google Scholar 

  • Halligan S, Bartram CI (1996) Is digitation associated with proctographic abnormality? Int J Colorect Dis 11:167–171

    CAS  Google Scholar 

  • Halligan S, Bartram CI (1998) Anismus: Fact or fiction? Dis Colon Rectum 41:1070–1071

    CAS  PubMed  Google Scholar 

  • Halligan S, Nicholls RJ, Bartram CI (1995) Proctographic changes following rectopexy for solitary rectal ulcer syndrome and preoperative predictive factors for a successful outcome. Br J Surg 82:314–317

    CAS  PubMed  Google Scholar 

  • Halligan S, Nicholls RJ, Bartram CI (1995) Evacuation proctography in patients with solitary rectal ulcer syndrome: anatomic abnormalities and frequency of impaired emptying and prolapse. AJR 164:91–95

    CAS  PubMed  Google Scholar 

  • Halligan S, Thomas J, Bartram CI (1995) Intrarectal pressures and balloon expulsion related to evacuation proctography. Gut 31:100–104

    Google Scholar 

  • Halligan S, Bartram CI, Park HY, Kamm MA (1995) The proctographic features of anismus. Radiology 197:679–682

    CAS  PubMed  Google Scholar 

  • Halligan S, Bartram C, Hall C, Wingate J (1996) Enterocele revealed by simultaneous evacuation proctography and peritoneography: does “defecation block” exist? AJR 167:461–466

    CAS  PubMed  Google Scholar 

  • Halligan S, Malouf A, Bartram CI, Marshall MM, Hollings N, Kamm MA (2001) Predictive value of impaired proctographic evacuation for diagnosis of anismus. AJR 177:633–636

    CAS  PubMed  Google Scholar 

  • Harewood GC, Coulie B, Camilleri M, Rath-Harvey D, Pemberton JH (1999) Descending perineum syndrome: audit of clinical and laboratory features and outcome of pelvic floor retraining. Am J Gastroenterol 94:126–130

    CAS  PubMed  Google Scholar 

  • Harvey C, Halligan S, Bartram CI, Hollings N, Shadev A, Kingston K (1999) Evacuation Proctography: A prospective study of diagnostic and therapeutic impact. Radiology 211:223–227

    CAS  PubMed  Google Scholar 

  • Heaton KW, Ghosh S, Braddon FEM (1991) How bad are the symptoms and bowel dysfunction of patients with the irritable bowel syndrome? A prospective controlled study with emphasis on stool form. Gut 32:73–79

    CAS  PubMed  Google Scholar 

  • Healy JC, Halligan S, Reznek RH, Watson S, Bartram CI, Kamm MA, Phillips RKS, Armstrong P (1997) Dynamic magnetic resonance imaging of the pelvic floor in patients with obstructed defecation. Br J Surg 84:1555–1558

    CAS  PubMed  Google Scholar 

  • Henry MM, Parks AG, Swash M (1982) The pelvic floor in the descending perineum syndrome. Br J Surg 69:470–472

    CAS  PubMed  Google Scholar 

  • Hiltunen KM, Kolehmainen H, Matikainen M (1994) Does defaecography help in diagnosis and clinical decision making in defecation disorders? Abdom Imaging 19:355–358

    CAS  PubMed  Google Scholar 

  • Hinton JM, Lennard-Jones JE, Young AC (1969) A new method for studying gut transit times using radio-opaque markers. Gut 10:842–847

    CAS  PubMed  Google Scholar 

  • Hoffman MJ, Kodner IJ, Fry RD (1984) Internal intussusception of the rectum: Diagnosis and surgical management. Dis Colon Rectum 27:435–441

    CAS  PubMed  Google Scholar 

  • Ihre T (1990) Intussusception of the rectum and the solitary rectal ulcer syndrome. Ann Med 22:419–423

    CAS  PubMed  Google Scholar 

  • Johanson JF, Sonnenberg A, Koch TR (1989) Clinical epidemiology of chronic constipation. J Clin Gastroenterol 11:525–536

    CAS  PubMed  Google Scholar 

  • Johansson C, Nilsson BY, Holmstrom B, Dolk A, Mellgren A (1992) Association between rectocele and paradoxical sphincter response. Dis Colon Rectum 35:503–509

    CAS  PubMed  Google Scholar 

  • Johansson CJ, Ihre T, Ahlback SO (1985) Disturbances in the defecation mechanism with special reference to intussusception of the rectum. Dis Colon Rectum 28:920–924

    CAS  PubMed  Google Scholar 

  • Jones PN, Lubowski DZ, Swash M, Henry MM (1987) Is paradoxical contraction of puborectalis muscle of functional importance? Dis Colon Rectum 30:667–670

    CAS  PubMed  Google Scholar 

  • Jorge JMN, Wexner SD, Ehrenpreis ED, Nogueras JJ, Jagelman DG (1993) Does perineal descent correlate with pudendal neuropathy? Dis Colon Rectum 36:475–483

    CAS  PubMed  Google Scholar 

  • Jorge JM, Wexner SD, Ger GC, Salanga VD, Nogueras JJ, Jagelman DG (1993) Cinedefecography and electromyography in the diagnosis of nonrelaxing puborectalis syndrome. Dis Colon Rectum 36:668–676

    CAS  PubMed  Google Scholar 

  • Kamm MA, Hawley PR, Lennard-Jones JE (1988) Outcome of colectomy for severe idiopathic constipation. Gut 29:969–973

    CAS  PubMed  Google Scholar 

  • Kamm MA, Bartram CI, Lennard-Jones JE (1989) Rectodynamics-Quantifying rectal evacuation. Int J Colorect Dis 4:161–163

    CAS  Google Scholar 

  • Karlbom U, Graf W, Nilsson S, Påhlman L (2004) The accuracy of clinical examination in the diagnosis of rectal intussusception. Dis Colon Rectum 47:1533–1538

    PubMed  Google Scholar 

  • Kelvin FM, Maglinte DDT, Hornback JA, Benson JT (1992) Pelvic prolapse: assessment with evacuation proctography (defecography). Radiology 184:547–551

    CAS  PubMed  Google Scholar 

  • Kelvin FM, Maglinte DDT, Benson JT, Pittman JS (1995) Re: The role of defecography in clinical practice. Abdom Imaging 20:279–280

    CAS  PubMed  Google Scholar 

  • Kelvin FM, Maglinte DDT (1997) Dynamic cystoproctography of female pelvic floor defects and their interrelationships. AJR 169:769–774

    CAS  PubMed  Google Scholar 

  • Klauser AG, Voderholzer WA, Heinrich CA, Schindlbeck NE, Muller-Lissner SA (1990) Behavioural modification of colonic function: can constipation be learned? Dig Dis Sci 35:1271–1275

    CAS  PubMed  Google Scholar 

  • Knowles CH, Scott SM, Wellmer A, Misra VP, Pilot MA, Williams NS, Anand P (1999) Sensory and autonomic neuropathy in patients with idiopathic slow transit constipation. Br J Surg 86:54–60

    CAS  PubMed  Google Scholar 

  • Kuijpers HC, Bleijenberg G (1986) The spastic pelvic floor syndrome: A cause of constipation. Dis Colon Rectum 28:669–672

    Google Scholar 

  • Kuijpers HC, Bleijenberg G, de Morree H (1986) The spastic pelvic floor syndrome. Large bowel outlet obstruction caused by pelvic floor dysfunction-a radiological study. Int J Colorect Dis 1:44–48

    CAS  Google Scholar 

  • Lane WA (1913) An address on chronic intestinal stasis. BMJ ii:1126

    Google Scholar 

  • Laarhoven CJHM, Kamm MA, Bartram CI, Halligan S, Hawley PR, Phillips RKS (1999) Relationship between anatomic and symptomatic long-term results after rectocele repair for impaired defecation. Dis Colon Rectum 42:204–211

    PubMed  Google Scholar 

  • Lau CW, Heymen S, Alabaz O, Iroatulam AJ, Wexner SD (2000) Prognostic significance of rectocele, intussusception and abnormal perineal descent in biofeedback treatment for constipated patients with paradoxical puborectalis contraction. Dis Colon Rectum 43:478–482

    CAS  PubMed  Google Scholar 

  • Leroi AM (1995) Anismus as a marker of sexual abuse: consequences of abuse on anorectal motility. Dig Dis Sci 40:1411–1416

    CAS  PubMed  Google Scholar 

  • Liberman H, Hughes C, Dippolito (2000) Evaluation and outcome of the Delorme procedure in the treatment of rectal outlet obstruction. Dis Colon Rectum 43:188–192

    CAS  PubMed  Google Scholar 

  • Lienemann A, Anthuber C, Baron A, Kohz P, Reiser M (1997) Dynamic MR colpocystorectography assessing pelvic floor descent. Eur Radiol 7:1309–1317

    CAS  PubMed  Google Scholar 

  • Loder P, Watson S, Halligan S, Bartram CI, Phillips RKS (1996) Transperineal repair of symptomatic rectocoele with marlex mesh: A clinical, physiological and radiological assessment of treatment. J Am Coll Surg 183:257–261

    PubMed  Google Scholar 

  • Marshall M, Halligan S, Fotheringham T, Bartram C, Nicholls RJ (2002) Predictive value of internal anal sphincter thickness for diagnosis of rectal intussusception in patients with solitary rectal ulcer syndrome. Br J Surg 89:1281–1285

    CAS  PubMed  Google Scholar 

  • McKee RF, McEnroe L, Anderson JH, Finlay IG (1999) Identifi cation of patients likely to benefit from biofeedback for outlet obstruction constipation. Br J Surg 86:355–359

    CAS  PubMed  Google Scholar 

  • McGee SG, Bartram CI (1993) Intra-anal intussusception: diagnosis by posteroanterior stress proctography. Abdom Imaging 2:136–140

    Google Scholar 

  • Mellgren A, Schultz I, Johansson C, Dolk A (1997) Internal rectal intussusception seldom develops into total rectal prolapse. Dis Colon Rectum 40:817–820

    CAS  PubMed  Google Scholar 

  • Mellgren A, Lopez A, Schultz I, Anzen B (1998) Rectocele is associated with paradoxical anal sphincter reaction. Int J Colorect Dis 13:13–16

    CAS  Google Scholar 

  • Mimura T, Roy AJ, Storrie JB, Kamm MA (2000) Treatment of impaired defecation associated with rectocele by behavioural retraining (biofeedback). Dis Colon Rectum 43:1267–1272

    CAS  PubMed  Google Scholar 

  • Morio O, Meurette G, Desfourneaux V, D’Halluin PN, Bretagne JF, Siproudhis L (2005) Anorectal physiology in solitary ulcer syndrome: a case-matched series. Dis Colon Rectum 48:1917–1922

    PubMed  Google Scholar 

  • Murthy VK, Orkin BA, Smith LE, Glassman LM (1996) Excellent outcome using selective criteria for rectocele repair. Dis Colon Rectum 39:374–378

    CAS  PubMed  Google Scholar 

  • Oettle GJ, Roe AM, Bartolo DC, Mortensen NJ (1985) What is the best way of measuring perineal descent? A comparison of radiographic and clinical methods. Br J Surg 72:999–1001

    CAS  PubMed  Google Scholar 

  • Orrom WJ, Bartolo DCC, Miller R, Mortensen NJ, Roe AM (1991) Rectopexy is an ineffective treatment for obstructed defecation. Dis Colon Rectum 34:41–46

    CAS  PubMed  Google Scholar 

  • Ott DJ, Donati DL, Kerr RM, Chen MYM (1994) Defecography: results in 55 patients and impact on clinical management. Abdom Imaging 9:349–354

    Google Scholar 

  • Parks AG, Porter NH, Hardcastle JD (1966) The syndrome of the descending perineum. Proc R Soc Med 59:477–482

    CAS  PubMed  Google Scholar 

  • Pechlivanides G, Tsiaoussis J, Athanasakis E, Zervakis N, Gouvas N, Zacharioudakis G, Xynos E (2007) Stapled transanal rectal resection (STARR) to reverse the anatomic disorders of pelvic floor dyssynergia. World J Surg 31:1329–1335

    PubMed  Google Scholar 

  • Preston DM, Lennard-Jones JE, Thomas BM (1985) Towards a radiologic definition of idiopathic megacolon. Gastrointest Radiol 10:167–169

    CAS  PubMed  Google Scholar 

  • Preston DM, Lennard-Jones JE (1985) Anismus in chronic constipation. Dig Dis Sci 30:413–418

    CAS  PubMed  Google Scholar 

  • Preston DM, Lennard-Jones JE (1886) Severe chronic constipation of young women: idiopathic slow transit constipation. Gut 27:41–48

    Google Scholar 

  • Prior A, Maxton DG, Whorwell JP (1990) Anorectal manometry in irritable bowel syndrome: differences between diarrhoea and constipation predominant subjects. Gut 31:458–462

    CAS  PubMed  Google Scholar 

  • Probert CSJ, Emmett PM, Cripps HA, Heaton KW (1994) Evidence for the ambiguity of the term constipation: the role of the irritable bowel syndrome. Gut 35:1455–1458

    CAS  PubMed  Google Scholar 

  • Rao SS, Ozturk R, De Ocampo S, Stessman M (2006) Pathophysiology and role of biofeedback therapy in solitary rectal ulcer syndrome. Am J Gastroenterol 101:613–618

    CAS  PubMed  Google Scholar 

  • Read NW (1989) Tests of anorectal function: Summary and conclusions. In: Read NW, ed. Gastrointestinal motility: which test? Wrightson Biomedical Ltd. p. 277–282

    Google Scholar 

  • Read NW, Timms JM, Bannister JJ, Donnelly TC, Read MG (1986) Impairment of defecation in young women with severe constipation. Gastroenterology 90:53–60

    CAS  PubMed  Google Scholar 

  • Rex DR, Lappas JC, Goutet RC, Madura JA (1992) Selection of constipated subjects as subtotal colectomy candidates. J Clin Gastroenterol 15:212–217

    CAS  PubMed  Google Scholar 

  • Sandler RS, Drossman DA (1987) Bowel habits in young adults not seeking health care. Dig Dis Sci 32:841–845

    CAS  PubMed  Google Scholar 

  • Schoenberger AW, Debatin JF, Guldenschuh I, Hany TF, Steiner P, Krestin GP (1998) Dynamic MR defecography with a superconducting, open-configuration MR system. Radiology 206:641–646

    Google Scholar 

  • Shorvon PJ, McHugh S, Diamant NE, Somers S, Stevenson GW (1989) Defecography in normal volunteers: results and implications. Gut 30:1737–1749

    CAS  PubMed  Google Scholar 

  • Skomorowska E, Hegedus V, Christiansen J (1988) Evaluation of perineal descent by defaecography. Int J Colorect Dis 3:191–194

    CAS  Google Scholar 

  • Sun WM, Read NW, Donnelly TC, Bannister JJ, Shorthouse AJ (1989) A common pathophysiology for full thickness rectal prolapse, anterior mucosal prolapse and solitary rectal ulcer. Br J Surg 76:290–295

    CAS  PubMed  Google Scholar 

  • Talley NJ, Weaver AL, Zinmeister AR, Melton LJ (1993) Functional constipation and outlet delay: A population based study. Gastroenterology 105:781–790

    CAS  PubMed  Google Scholar 

  • van Tets WF, Kuijpers JHC (1995) Internal rectal intussusception-fact or fancy? Dis Colon Rectum 38:1080–1083

    PubMed  Google Scholar 

  • Thompson WG, Dotevall G, Drossman DA, Heaton KW, Kruis W (1989) Irritable bowel syndrome: guidelines for the diagnosis. Gastroenterol Int 2:92–95

    Google Scholar 

  • Thorpe AC, Williams NS, Badenoch DF, Blandy JP, Grahn MF (1993) Simultaneous electromyographic proctography and cystometrography. Br J Surg 80:115–120

    CAS  PubMed  Google Scholar 

  • Tjandra JJ, Ooi BS, Tang CL, Dwyer P, Carey M (1999) Transanal repair of rectocele corrects obstructed defecation if it is not associated with anismus. Dis Colon Rectum 42:1544–1550

    CAS  PubMed  Google Scholar 

  • Turnbull GK, Bartram CI, Lennard-Jones JE (1988) Radiologic studies of rectal evacuation in adults with idiopathic constipation. Dis Colon Rectum 31:190–197

    CAS  PubMed  Google Scholar 

  • Tuttle JP (1903) A treatise on the diseases of the anus, rectum and pelvic colon. Appleton, New York and London p. 961

    Google Scholar 

  • van Dam JH, Hop WC, Schouten WR (2000) Analysis of patients with poor outcome of rectocele repair. Dis Colon Rectum 43:1556–1560

    PubMed  Google Scholar 

  • Wasserman IF (1964) Puborectalis syndrome (rectal stenosis due to anorectal spasm). Dis Colon Rectum 7:87–98

    CAS  PubMed  Google Scholar 

  • Whorton J (2000) Civilisation and the colon: constipation as the “diseases of diseases.” BMJ 321:1586–1589

    CAS  PubMed  Google Scholar 

  • Womack NR, Williams NS, Holmfield JH, Morrison JF (1987) Pressure and prolapse: the cause of the solitary rectal ulcer syndrome. Gut 28:1228–1233

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

Copyright information

© 2008 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Halligan, S. (2008). Constipation and Prolapse. In: Imaging Pelvic Floor Disorders. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-71968-7_14

Download citation

  • DOI: https://doi.org/10.1007/978-3-540-71968-7_14

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-71966-3

  • Online ISBN: 978-3-540-71968-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics