Document Detail

Treatment strategies for chronic constipation: our experience.
MedLine Citation:
PMID:  18837251     Owner:  NLM     Status:  MEDLINE    
Outlet dysfunction is responsible for 25% of all cases of chronic constipation. The aim of this article was to report our outcomes and investigate the efficacy of the different treatments that we have adopted to solve it. One hundred and twenty-six patients were treated with either surgery and/or biofeedback therapy. Ninety-seven of the 126 patients underwent surgery; 48 with hidden rectal prolapse: 44 underwent a stapled transanal rectal resection using a double stapler PPH-01 and 4 a single stapler PPH-01; 31 with rectocele and 18 with both hidden rectal prolapse and rectocele, respectively, underwent a stapled transanal rectal resection using a double stapler PPH-01. Thirteen of 97 patients showing outlet dysfunction in spite of surgery progressed to biofeedback therapy. 29 of the 126 patients were treated with biofeedback training only. Surgery helped 51.6% of treated for rectocele, 75% of those treated for hidden rectal prolapse, and 78% of patients treated for both rectocele and hidden rectal prolapse, respectively. Approximately 80% of patients treated with biofeedback alone and 67.8% of those treated with both surgery and biofeedback reported an improvement, respectively. Treatment of the outlet dysfunction can be difficult. The therapeutic option chosen for each subject in spite of a careful functional patient examination may not prove to be the most appropriate one. Our experience suggests that the surgery of the obstructed defecation could achieve better outcomes if a course of biofeedback therapy precedes it, above all in patients with both organic and functional disorders, and the repair of rectocele with stapled transanal rectal resection fails to resolve the outlet dysfunction in several cases.
Lino Succi; Conchita Emanuela Oliveri; Antonino Carlo Privitera; Giuseppe Randazzo; Nnawuihe Luca Ohazuruike; Serafina Prumeri; Antonino Politi
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Chirurgia italiana     Volume:  60     ISSN:  0009-4773     ISO Abbreviation:  Chir Ital     Publication Date:    2008 Jul-Aug
Date Detail:
Created Date:  2008-10-07     Completed Date:  2008-12-03     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  0151753     Medline TA:  Chir Ital     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  509-18     Citation Subset:  IM    
Dipartimento di Scienze Chirurgiche, Trapianti d'Organo e Tecnologie Avanzate, Università degli Studi, Catania.
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MeSH Terms
Aged, 80 and over
Biofeedback, Psychology
Chronic Disease
Constipation / surgery,  therapy*
Middle Aged
Young Adult

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