Management of Obstructed Defecation

Overview

Journal World J Gastroenterol

Publisher Baishideng Publishing Group

Specialty Gastroenterology

Date 2015 Jan 30

PMID 25632177

Citations 23

Authors

Vlasta Podzemny

Lorenzo Carlo Pescatori

Mario Pescatori

Affiliations

Soon will be listed here.

Abstract

The management of obstructed defecation syndrome (ODS) is mainly conservative and mainly consists of fiber diet, bulking laxatives, rectal irrigation or hydrocolontherapy, biofeedback, transanal electrostimulation, yoga and psychotherapy. According to our experience, nearly 20% of the patients need surgical treatment. If we consider ODS an "iceberg syndrome", with "emerging rocks", rectocele and rectal internal mucosal prolapse, that may benefit from surgery, at least two out of ten patients also has "underwater rocks" or occult disorders, such as anismus, rectal hyposensation and anxiety/depression, which mostly require conservative treatment. Rectal prolapse excision or obliterative suture, rectocele and/or enterocele repair, retrograde Malone's enema and partial myotomy of the puborectalis muscle are effective in selected cases. Laparoscopic ventral sacral colporectopexy may be an effective surgical option. Stapled transanal rectal resection may lead to severe complications. The Transtar procedure seems to be safer, when dealing with recto-rectal intussusception. A multidisciplinary approach to ODS provides the best results.

Citing Articles

Long-Term Outcomes of Transvaginal Sacrospinous Ligament Suture Rectopexy.

Chill H, Hadizadeh A, Leffelman A, Paya Ten C, Chang C, Goldberg R Int Urogynecol J. 2025; .

PMID: 40042604 DOI: 10.1007/s00192-025-06099-w.

Short-Term Complications Following Transvaginal Sacrospinous Ligament Rectopexy: A Retrospective Cohort Study.

Hadizadeh A, Chill H, Leffelman A, Paya-Ten C, Chang C, Lee J Int Urogynecol J. 2025; .

PMID: 40019590 DOI: 10.1007/s00192-025-06098-x.

Sexual Dimorphism in the Architectural Design of Rat and Human Pelvic Floor Muscles.

Routzong M, Rieger M, Cook M, Ukkan R, Alperin M J Biomech Eng. 2024; 146(10).

PMID: 39082779 PMC: 11369689. DOI: 10.1115/1.4066090.

Results of medical treatment with psyllium, lactobacillus, and tryptophan (Plurilac® Trio) in obstructive defecation syndrome.

Valiyeva S, Tiso D, Cerri P, Pisciaroli A, Pietroletti R Front Surg. 2024; 11:1361049.

PMID: 38650661 PMC: 11033349. DOI: 10.3389/fsurg.2024.1361049.

Prevalence of Obstructed Defecation among Patients Who Underwent Hemorrhoidectomy and Correlation between Preoperative Constipation Score and Postoperative Patients' Satisfaction: A Prospective Study in Two Centers.

Abd El Maksoud W, Abbas K, Bawahab M, Rayzah F, Alkorbi S, Alfaifi A Healthcare (Basel). 2023; 11(5).

PMID: 36900764 PMC: 10001578. DOI: 10.3390/healthcare11050759.

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