[Obstructed defecation syndrome - review article]

Abstract

Introduction: Obstructed defecation syndrome (ODS) is one of the main causes of primary constipation. It is caused by anatomical disorders in the pelvic floor region (rectocoele, en-terocoele, rectal intussusception, rectal prolapse), but it always occurs in combination with a functional defect of defecation. This review provides a comprehensive view of the diagnosis and treatment of the syndrome.

Method: Treatment may be conservative or surgical. Conservative treatment involves a complex of approaches to the practice of defecation, regime and dietary measures together with pelvic floor rehabilitation and psychological support. The symptoms of ODS persist in some patients despite conservative treatment and this is why these patients are eligible for surgery. Surgical approaches can be divided into transvaginal, transabdominal and transanal. Transanal procedures, associated with good short-term results and low complication rates, are used most frequently. Long-term results are still under discussion.

Conclusions: Since ODS is caused by the combination of functional and anatomical disorders, treatment has to be targeted at a wide range of causes. Therefore, only a multidisciplinary approach as well as a combination of conservative treatment and strictly and correctly indicated surgical procedures can lead to good long-term results.Key words: ODS - rectocoele - intussusception - STARR.