Diagnosis and Conservative Treatment of Functional Disorders of Defecation

Abstract

90 patients (female 72 (80%), male 18 (20%), mean age 43,6±16,5 y.o.) with functional disorders of defecation (dyssynergic defecation and inadequate propulsion) were included in the study. All the patients conformed the Rome III (2006) criteria for functional constipation. Highresolution anorectal manometry (HRAM) procedures (London protocol) were performed using Solar GI system (MMS, The Netherland) with 8-channel water-perfusion catheters. All the patients underwent a course of biofeedback therapy for obstructive defecation (Urostim, Laborie, Canada). The course consisted of 10 daily 30-minutes long sessions. Treatment efficacy was evaluated after the completion of biofeedback therapy according to the control HRAM. CONCLUSIONS. Biofeedback is the method of choice for treatment of patients with obstructive defecation syndrome with pelvic floor dyssynergia and spasm of m.puborectalis. At the same time biofeedback therapy is ineffective in patients with type III of manometry pattern and in patients with an inadequate propulsion.