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Related Experiment Videos

[Obstructed defecation].

H-P Bruch1, F Fischer, T H K Schiedeck

  • 1Klinik für Chirurgie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany. bruch@uni-luebeck.de

Der Chirurg; Zeitschrift Fur Alle Gebiete Der Operativen Medizen
|July 20, 2004
PubMed
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Treating obstructed defecation requires differentiating causes like pelvic outlet obstruction or slow transit constipation. Accurate diagnosis through imaging and patient selection are key for effective therapy, especially distinguishing surgical from conservative options.

Area of Science:

  • Gastroenterology
  • Colorectal Surgery
  • Pelvic Floor Disorders

Background:

  • Obstructed defecation presents a complex therapeutic challenge due to diverse etiologies and symptoms.
  • Differentiating between pelvic outlet obstruction and slow transit constipation is essential for appropriate management.
  • Distinguishing between structural/morphologic abnormalities and functional disorders of the colon, rectum, and pelvic floor is critical.

Purpose of the Study:

  • To outline a standardized diagnostic approach for obstructed defecation.
  • To differentiate between causes amenable to surgery versus conservative management.
  • To emphasize the importance of patient selection for surgical interventions.

Main Methods:

  • Utilizing defecography and dynamic MRI of the pelvic floor for diagnosis.

Related Experiment Videos

  • Assessing morphologic changes (e.g., sigmoidoceles, rectal prolapse) and functional disorders (e.g., rectoanal dyssynergia).
  • Reviewing diagnostic criteria and therapeutic options for various obstructed defecation subtypes.

    • Main Results:

    • Defecography and dynamic pelvic floor MRI accurately diagnose conditions like sigmoidoceles and rectal prolapse, often requiring surgery.
    • Diagnosis and treatment strategies for symptomatic rectocele and intussusception remain debated.
    • Functional disorders, such as rectoanal dyssynergia, are typically managed conservatively with biofeedback.

    Conclusions:

    • Careful patient selection is paramount to identify individuals who will benefit from surgery for obstructed defecation.
    • A systematic diagnostic process is crucial for tailoring therapy to the specific cause of obstructed defecation.
    • Integrating imaging and functional assessments guides treatment decisions in complex defecatory disorders.