Assessment and Treatment of Obstructed Defecation Syndrome

Linardoutsos, Dimitrios

doi:10.5772/intechopen.86268

Cited by 2 publications

(3 citation statements)

References 35 publications

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“…The most common cause of ODS is mechanical obstruction from either structural abnormalities (e.g., rectocele and rectal prolapse) or functional abnormalities (e.g., pelvic dyssynergia). A huge pedunculated polyp may cause persistent internal recto-rectal intussusception presenting as rectal prolapse, especially during bearing down, which could be the mechanical precursor to ODS [ 6 , 7 ]. Besides intussusception, a huge polyp can also lead to luminal obstruction and overdistension of the rectum.…”

Section: Discussionmentioning

confidence: 99%

“…Besides intussusception, a huge polyp can also lead to luminal obstruction and overdistension of the rectum. Chronic distension of the rectum leads to hyposensitivity followed by paradoxical rectal contraction, leading to overflow incontinence, which is the seepage type with a sensation of incomplete evacuation requiring frequent toilet visits [ 7 ]. These symptoms are similar to those in our case upon presentation, which resolved immediately after resection.…”

Section: Discussionmentioning

confidence: 99%

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A case report of a giant solitary juvenile polyp: from obstructed defecation syndrome to incontinence

et al. 2024

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Juvenile polyps (JPs) are the most common polyps in pediatric patients. We present the case of an 18-year-old male patient with a giant solitary JP resembling solitary rectal ulcer syndrome (SRUS). The presenting history was rectal bleeding and symptoms of obstructed defecation syndrome. Colonoscopy revealed a polypoidal mass at the anorectal junction, with biopsy-confirmed SRUS. The symptoms worsened, and a protruding mass from the anus caused fecal incontinence. Pelvic magnetic resonance imaging showed a huge pedunculated mass occupying the low rectum with local compression of the urinary bladder. Transanal excision of the anal tumor was performed due to bleeding. A histopathological examination showed a JP with high-grade dysplasia. A histological examination to differentiate JPs and SRUS could be challenging based on a superficial forceps biopsy. Therefore, an excision biopsy is usually warranted with the understanding that adenomatous or malignant transformation is found in 5.6% to 12% of all JPs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A case report of a giant solitary juvenile polyp: from obstructed defecation syndrome to incontinence

et al. 2024

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“…Symptoms of ODS include rectal or lower abdominal pain, incomplete rectal evacuation, the use of digitation or perineal manipulation to help the defecation, straining, spending prolonged time in toilet, perineal descent, report of hard stools, as well as dependency on laxatives and enemas [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Surgical Treatment for Rectocele by Posterior Colporrhaphy Compared to Stapled Transanal Rectal Resection

Gluck

Matani

Rosen

et al. 2023

JCM

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Background: Rectocele is defined as a defect in the rectovaginal septum, causing symptoms like obstructed defecation syndrome (ODS), vaginal bulging, etc. Once the rectocele is larger than 3 cm and/or symptomatic, surgery should be considered. The surgical approach can be either transvaginal, transanal or transperineal. Two of the most common procedures in treating rectocele are posterior colporrhaphy (PC) and stapled trans anal rectal resection (STARR). The purpose of this study was to compare surgical outcomes of both procedures. Methods: This is a retrospective cohort study. Included were patients of the age of 18–85 years that underwent either STARR (n = 49 patients) or PC (n = 24 patients) procedures after a full clinical (defecography and physical exam before and after the surgery) and physiologic (a detailed questionnaire before and after the surgery) surveys. Symptoms of ODS before and after surgery were evaluated by questioners. Results: Preoperatively, the patients in the STARR group had significantly higher rates of ODS: straining (90.9% vs. 65.2%), incomplete evacuation (100% vs. 69.6%), hard stool (57.8% vs. 43.5%), sense of obstruction (76.1% vs. 56.5%), and use of digitation (64.4% vs. 47.8%), or laxatives (70% vs. 47.8%), p < 0.001. Anatomically, the mean rectocele size was smaller for the STARR group, compared to the PC group (3.8 ± 1.4 vs. 5.3 ± 2.2 cm, respectively, p < 0.001). Postoperatively, in the STARR group, higher rates of patients complained about straining (36.4% vs. 21.7%, p < 0.001) and use of digitation (64.4% vs. 26.1%, p < 0.001), whereas lower rates of patients complained about incomplete evacuation (41.2% vs. 56.5%, p = 0.05) and sense of obstruction (17.6%, vs. 34.8%, p = 0.03), compared to the PC group. Among patients who underwent the STARR procedure, a decrease in rates of all symptoms was noted (straining 54.5%, incomplete evacuation 58.8%, hard stool 29.2%, sense of obstruction 58.5%, use of digitation 0.1%, and use of laxatives 31.5%). Both procedures are effective in reducing rectocele size (STARR- 1.9 ± 1 cm, PC- 3.1 ± 1). Conclusions: Both STARR and PC are effective in treating rectocele. It seems that the STARR procedure is superior to the PC procedure in treating symptoms of ODS.

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Assessment and Treatment of Obstructed Defecation Syndrome

Cited by 2 publications

References 35 publications

A case report of a giant solitary juvenile polyp: from obstructed defecation syndrome to incontinence

A case report of a giant solitary juvenile polyp: from obstructed defecation syndrome to incontinence

Surgical Treatment for Rectocele by Posterior Colporrhaphy Compared to Stapled Transanal Rectal Resection

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