[Obstructed Defecation Syndrome: Aetiology, Diagnostic Assessment and Therapeutic Options]

Obstructed defecation syndrome (ODS) is characterized by disturbed defecation, and morphological disorders can be differentiated from functional pathologies. Differential diagnosis from irritable bowel syndrome and slow transit constipation is frequently difficult. Most patients are female, and rectal intussusception and anterior rectocele are frequent morphological pathologies. In addition to patients' history and basic proctological diagnostic testing, MR defecography plays a central role. As ODS is a benign condition, conservative treatment should be initiated primarily. After failure of conservative treatment and in terms of a morphological disorder, the indication for surgery should be discussed, whereas transabdominal procedures (e.g. resection rectopexy, rectopexy) and transanal procedures (e.g. STARR) are available. Adequate therapy remains a challenge due to multifactorial aetiology and the variety of symptoms - this affects both conservative and surgical treatment options.