{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T19:13:34Z","timestamp":1771701214612,"version":"3.50.1"},"reference-count":36,"publisher":"FapUNIFESP (SciELO)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq. Gastroenterol."],"published-print":{"date-parts":[[2012,6]]},"abstract":"<jats:p>CONTEXT: Management of patients with obstructed defecation syndrome is still controversial. OBJECTIVE: To analyze the efficacy of clinical, clinical treatment followed by biofeedback, and surgical treatment in patients with obstructed defecation, rectocele and multiple dysfunctions evaluated with echodefecography. METHODS: The study included 103 females aged 26-84 years with obstructed defecation, grade-II\/III rectocele and multiple dysfunctions on echodefecography. Patients were distributed into three treatment groups and constipation scores were assigned. Group I: 34 (33%) patients with significant improvement of symptoms through clinical management only. Group II: 14 (14%) with improvement through clinical treatment plus biofeedback. Group III: 55 (53%) referred to surgery due to treatment failure. RESULTS: Group I: 20 (59%) patients had grade-II rectocele, 14 (41%) grade-III. Obstructed defecation syndrome was associated with intussusception (41%), mucosal prolapse (41%), anismus (29%), enterocele (9%) or 2 dysfunctions (23%). The average constipation score decreased significantly from 11 to 5. Group II: 11 (79%) grade-II rectocele, 3 (21%) grade-III, associated with intussusception (7%), mucosal prolapse (43%), anismus (71%) or 2 dysfunctions (29%). There was significant decrease in constipation score from 13 to 6. Group III: 8 (15%) grade-II rectocele, 47 (85%) grade-III, associated with intussusception (42%), mucosal prolapse (40%) or 2 dysfunctions (32%). The constipation score remained unchanged despite clinical treatment and biofeedback. Twenty-three underwent surgery had a significantly decrease in constipation score from 12 to 4. The remaining 32 (31%) patients which 22 refused surgery, 6 had low anal pressure and 4 had slow transit. CONCLUSIONS: Approximately 50% of patients with obstructed defecation, rectocele and multiple dysfunctions presented a satisfactory response to clinical treatment and\/or biofeedback. Surgical repair was mainly required in patients with grade-III rectocele whose constipation scores remained high despite all efforts.<\/jats:p>","DOI":"10.1590\/s0004-28032012000200008","type":"journal-article","created":{"date-parts":[[2012,7,4]],"date-time":"2012-07-04T22:49:37Z","timestamp":1341442177000},"page":"135-142","source":"Crossref","is-referenced-by-count":19,"title":["Management of patients with rectocele, multiple pelvic floor dysfunctions and obstructed defecation syndrome"],"prefix":"10.1590","volume":"49","author":[{"given":"Sthela Maria","family":"Murad-Regadas","sequence":"first","affiliation":[{"name":"Federal University of Cear\u00e1"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco Sergio P.","family":"Regadas","sequence":"additional","affiliation":[{"name":"Federal University of Cear\u00e1"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lusmar Veras","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Federal University of Cear\u00e1"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Graziela Olivia da Silva","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Federal University of Cear\u00e1, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guilherme","family":"Buchen","sequence":"additional","affiliation":[{"name":"Federal University of Cear\u00e1, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Viviane T.","family":"Kenmoti","sequence":"additional","affiliation":[{"name":"Federal University of Cear\u00e1, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1007\/BF02056950","article-title":"A constipation scoring system to simplify evaluation and management of constipated patients","volume":"39","author":"Agachan 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