DIFFERENTIAL DIAGNOSTIC TECHNIQUE FOR EVACUATION DYSFUNCTIONS OF RECTUS AND URINARY BLADDER IN CHILDREN

摘要

FIELD: medicine.;SUBSTANCE: ultrasonic transperineal examination is conducted in a patient suffering disturbed defecation and/or urination and lying on his/her left side; a sensor is placed into a rectal fossa directly and relocated in the process to improve imaging of the examined organs: in boys from a scrotum root, in girls to a vaginal vestibule; the scanning procedure extends in two perpendicular projections - longitudinal and longitudinally oblique; the longitudinal scanning involves examining the rectus and perianal area and assessing the echigraphic anatomy of the anal canal and neck of urinary bladder with an urethra in details, as well as the rectal ampulla state; the anal canal length and width are measured; the presence and integrity of anal sphincters are stated, including: inner and outer; that is followed by measuring their thickness, an anorectal angle, a blood velocity in the anorectal vessels; at the border of the rectal ampulla transition into the anal canal, the sensor is arranged in the longitudinally oblique projection; a branch of a puborectal loop is located with measuring its thickness; examining the urinary bladder involves measuring the length and width of the neck with urethra and the posterior urethral-vesical angle. The examination is performed in rest and with exerted Valsalva manoeuvre and continence test by volitional contraction of perineum to determine the direction of the neck motion: forward to a symphysis or backward to a sacral bone; the derived values are compared to a normal value, and the established criteria are used to diagnose a variant of the dysfunction of the rectum and/or urinary bladder taking into account the quantities of the above criteria demonstrated in the patent claim.;EFFECT: technique provides the accurate qualitative-quantitative non-invasive informative objective differential diagnosis of the above dysfunctions.;3 ex