IMPORTANCE More information is needed to guide referring subspecialists on the appropriate patient evaluation before magnetic resonance defecography (MRD). OBJECTIVES This study aimed to evaluate how often health care providers perform digital rectal examination (DRE) before ordering MRD to investigate causes of bowel and pelvic floor complaints. STUDY DESIGN We conducted a retrospective cohort review, including MRD performed on female patients at an integrated health care system from 2016 through 2020. The primary outcome was the presence or absence of documented rectal examination in the year before defecography by the referring provider or 6 months prior by a primary care physician or pelvic floor physical therapist. We hypothesized that the overall rate of rectal examination would be high and unaffected by the referring provider's subspecialty. RESULTS Three hundred-four defecography tests were performed, with 209 patients (68.8%) referred by gastroenterology providers and 95 (31.2%) from other specialties. Gastroenterologists performed DRE in 32.8% of patients, in contrast to 84.4% of patients referred by other specialties (P < 0.001). When comparing subspecialties that most commonly refer patients for MRD (gastroenterology, colorectal surgery and urogynecology), there was a statistically significant difference between gastroenterologists and colorectal surgeons (P < 0.001) as well as urogynecologists (P < 0.001) but no difference in the rate of rectal examination between colorectal surgeons and urogynecologists (P = 1.00). CONCLUSIONS At our single integrated health system, the rate of DRE before MRD testing varied significantly by specialty. Our findings highlight the need for better understanding of DRE utility in the algorithms for evaluation of bowel and pelvic floor disorders.

中文翻译：

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在磁共振排粪造影研究之前使用直肠检查。

重要性 需要更多信息来指导转诊专科医生在磁共振排粪造影 (MRD) 之前对患者进行适当的评估。目的 本研究旨在评估医疗保健提供者在进行 MRD 调查肠道和盆底不适原因之前进行直肠指检 (DRE) 的频率。研究设计 我们进行了一项回顾性队列审查，包括 2016 年至 2020 年在综合医疗保健系统中对女性患者进行的 MRD。主要结果是转诊提供者在排粪造影前一年或 6 个月内是否进行了直肠检查记录。事先由初级保健医生或盆底物理治疗师进行。我们假设直肠检查的总体比率会很高并且不受转诊提供者的亚专业的影响。结果 进行了 304 次排粪造影检查，其中 209 名患者 (68.8%) 由胃肠病学提供者转诊，95 名患者 (31.2%) 来自其他专业。胃肠病学家对 32.8% 的患者进行了 DRE，而其他专业转诊的患者中这一比例为 84.4% (P < 0.001)。当比较最常转诊患者进行 MRD 的亚专业（胃肠病学、结直肠外科和泌尿妇科）时，胃肠病学家和结直肠外科医生 (P < 0.001) 以及泌尿妇科医师 (P < 0.001) 之间存在统计学显着差异，但比率没有差异结直肠外科医生和泌尿妇科医生之间直肠检查的差异（P = 1.00）。结论 在我们单一的综合卫生系统中，MRD 检测前的 DRE 率因专业而异。我们的研究结果强调需要更好地理解 DRE 在评估肠道和盆底疾病的算法中的实用性。