Obstructive Defecation

Obstructive defecation can be caused by structural deformities due to hereditary, injury, or age, problems with your digestive tract, impacted stool, or neurologic issues.

Women who have had two or more children or had an injury during childbirth which damaged the fascia (the internal tissue that separates the vaginal wall and anus, leading to pelvic floor dysfunction) are at a greater risk for obstructive defecation.

Diagnosis

Your doctor will start with a medical history, do a physical examination, and perform other tests to diagnose obstructive defecation and its underlying cause.

Your doctor may recommend additional tests to aid in diagnosis including:

  • Colonoscopy to view the entire colon and look for abnormalities
  • Electromyography (EMG) to test for weakness in the pelvic floor muscles and the muscles surrounding the anus
  • Anal manometry to determine how well the muscles surrounding the anus are working
  • Dynamic defecography to assess bowel function
  • Sigmoidoscopy to view the sigmoid colon
  • Colonic marker studies to determine the efficiency of your digestive tract

Treatment may include:

  • Medications to alleviate constipation
  • Biofeedback to help you regain control of your muscles

Ventral Rectopexy

This is a keyhole operation performed for patients with external rectal prolapse, it is also used for patients with symptoms of obstructive defeacation or who have an internal prolapse (also known as rectal intussusception).

During the operation the lowest part of the bowel (rectum) mobilized on one side. A mesh made of polypropylene is fastened to the front of the rectum using stitches. The mesh is then fixed using special tacks to the bone at the back of the pelvis known as the sacrum. This has the effect of pulling up the bowel and preventing it prolapsing downwards.

The operation usually involves only 3 or 4 small incisions, no larger than 1cm. After the operation a drip is normally in place for 24 hours. Patients are allowed to eat and drink as soon as they feel able after the operation (usually the same day). A catheter (tube passed into the bladder) is required during the procedure and is usually removed the day after surgery.

Reports have shown that the robotic approach is safe and feasible for rectal prolapse.

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Treated Conditions

Hemorrhoid Removal
Pelvic Floor Disorders
Pelvic Floor
Fecal Incontinence
Anorectal Manometry
Anal Ultrasound
Obstructed Defecation
Rectal Prolapse

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Howard Kaufman, MD

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Address: 10 Congress Street, Suite 300 Pasadena, CA 91105

Phone: (626) 397-5896
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