ABSTRACT
Most investigators perform the examination with the patient seated on a specially constructed commode so that rectal evacuation is performed in a physiological position. The anorectal angle is the angle between the line of the anal canal and that of the rectum. More pronounced mucosal prolapse is frequent and anterior wall prolapse into the anal orifice is the norm in patients with a significant rectocele. Proctography is contributing to the understanding of physiological effects of surgical procedures. For instance, postanal repair has been shown in several studies not to affect the anorectal angle, and presumably works by increasing the length of the anal canal and, in particular, the high-pressure zone. Anal endosonography and magnetic resonance imaging are more likely proliferate, and the combination of these techniques with proctography is likely to produce such a powerful overview of the continence mechanism that laboratory data will become less important to patient management.
