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Obstructed Defecation: When Is Surgery Indicated?

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Current Common Dilemmas in Colorectal Surgery

Abstract

Obstructed defecation syndrome (ODS) may be secondary to anatomical or functional disorders related to the pelvic floor. Comprehensive history, physical exam, and testing help to determine which patients are candidates for surgical repair. Conservative management consists of a high fiber diet, laxative or promotility agents, mental and pelvic floor relaxation techniques, physiologic counseling, and biofeedback and should be trialed prior to considering surgical repair. For patients with anatomical defects such as enterocele, sigmoidocele, rectocele, intussusception, rectal prolapse, or excessive perineal descent, surgical correction of pelvic organ prolapse can be considered via abdominal, rectal, vaginal, or perineal approaches. Ventral rectopexy restores middle and posterior pelvic floor compartment anatomy and improves symptoms of ODS in patients with internal and external rectal prolapse, enterocele, and rectocele. However, restoring anatomy does not guarantee functional improvement.

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Author information

Authors and Affiliations

  1. Division of Colorectal Surgery, Mater Dei Hospital, Belo Horizonte, MG, Brazil

    Maria Emilia Carvalho e Carvalho

  2. Department of General Surgery, Division of Colorectal Surgery Stanford University, Palo Alto, CA, USA

    Brooke H. Gurland

Authors
  1. Maria Emilia Carvalho e Carvalho
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  2. Brooke H. Gurland
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Correspondence to Maria Emilia Carvalho e Carvalho .

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Editors and Affiliations

  1. London Health Sciences Centre, University Hospital, London, Ontario, Canada

    Christopher M. Schlachta

  2. Mount Sinai School of Medicine, New York, New York, USA

    Patricia Sylla

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Carvalho e Carvalho, M.E., Gurland, B.H. (2018). Obstructed Defecation: When Is Surgery Indicated?. In: Schlachta, C., Sylla, P. (eds) Current Common Dilemmas in Colorectal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-70117-2_17

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  • DOI: https://doi.org/10.1007/978-3-319-70117-2_17

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