I am the queen of misread defecography!!!!!!! A resident mistook what was a loop of small intestine for my sigmoid colon saying my sigmoid colon descended between my rectum and vagina (thus calling it a sigmoidocele when in reality it was an enterocele) the descening loops of small intestine.
THe surgery for sigmoidocele is removal of sigmoid colon as opined by 3 colorectal surgeons upon the misread scan. As I KNEW NOTHING at the time, I had my sigmoid colon removed as I was told it was squeezing my rectum shut from the outside thus leading to difficulty with rectal emptying, my presenting symptom.
LONG story short: The surgeons I got involved with also "fixed" a cystocele (bladder drop) mentioned on the wrong read scan report that was so tiny it was negliglble, thus the "fix" gave me bladder issues. These surgeons I unfortunately got involved with then removed the top of my rectum for unknown reasons along with my sigmoid colon then didn't send it to the lab, go figure. I did not have a rectal prolapse or any disease. Did not and would not have consented to removal of top of rectum nor of sigmoid resection had I known all I now know. These surgeons also resuspended my vagina from my backbone though my vagina was not prolapsing. Did not consent to that either. And yada yada you get the picture.
Upshot Internal scarring cost me the permanent loss of colon and rectum; I have bladder damage; and for 7 months could not eat due to small bowel being scarred basically shut.
All that really needed to be done was small bowel needed to be pushed back in my pelvis and the space through which it descended on push phase of the defecogram test needed to be sewed shut. Then I had a rectocele that needed to be repaired. All this could have just been done vaginally thus no need for any colon resection or any surgery that would be open and give me small bowel adhesions
I had to look for 13 months 11 surgeons and 7 medical centers to find help. All that could be done for me was lysis of small bowel adhesions and permenent ileostomy. I was lucky to find someone to do this and am praying all keeps working. SO far so good and it's been 4 years. I have issues with some foods but as long as I continue to be able to eat I am happy.
BUT, as far as how accurate are defecograms? ONLY AS ACCURATE AS THE PERSON WHO READS THEM!!!!!! ANd according to reviewers of my case surgery should never be planned only based on defecogram. Depending on your presenting symptom, nerve, muscle, and many other tests need to be done along with defecogram.
You say you have symptoms of rectal prolapse. Is is hanging out of you? or do you mean internal rectal prolapse (intussuception). Do you have troube passing stool or are you incontinent? Be sure a radiology doc has signed the report and not just a resident. The signature lines will say (R) for resident (T) for teacher. If a resident signs, be sure the teacher did too. I knew nothing of signature lines when I had my defecogram which lead to all I went through and nobody called it to my attention until after the fact either.
That was my experience. Not saying you will have the same, but all these tests are very subject to interpretation! A lot depends on the imaging machine, the contrast used, etc. Mine was on a Tesla upright .5 MRI with ultrasound gel for contrast. That machine, to my knowledge broke and was never replaced. Lucky for future patients. Talk about hitting the wrong place at the wrong time. Most Defecograms are done with xray toilet type thing and barium contrast to which I am allergic that is why I had the other kind of defecogram I just described. BUT I did not know at the time I COULD have had the xray kind but with baby oatmeal mixed with gastrograffin as contrast. I never thought to talk to the actual radiology doc. They are real people though usually behind the scenes, but I have found all of them since my disaster defecogram to be very approachable. If you have any questions, it is perfectly ok to arrange consult with the actual radiology doc. THis was just my experience. Good luck. Rosemary