Purpose:We investigate 2 diagnostic tests to assess the rectal filling state.Materials and Methods:The rectal filling state was assessed with transabdom-inal ultrasound or with digital rectal examination by 2 independent investigators in children with urological problems before a scheduled diagnostic or surgical urological procedure. A dilated rectum filled with stool or large amounts of (usually) hard stool were both considered as a rectal fecal mass. All investigations were performed with the patient under general anesthesia. The kappa test was used to evaluate agreement between transabdominal ultrasound and digital rectal examination.
Results:A total of 84 children (54 boys) with a median (p25–p75) age of 9.0 years (6.4–11) were eligible candidates. A rectal mass was found on transabdominal ultrasound and digital rectal examination in 32% and 41% of all children, respec-tively, with agreement between the 2 tests in 82.5%. Cohen’s kappa showed good agreement of 0.62 (95% CI 0.45–0.79) between transabdominal ultrasound and digital rectal examination. The median (IQR) diameter of the rectum was 3.3 cm (2.8–3.9) in children with a full rectum, and 2.5 cm (1.8–2.8) and 2.0 cm (1.5–2.2) in patients with a half filled and empty rectum, respectively.