Structural and Functional Defecographic Findings in Obstructed Defecation Syndrome: A Retrospective Study of 146 Patients

Aynur Safiyeva^1,2* , Nazim Gasimov¹ , Sabina Ramazanova³

Abstract. Objective: Obstructed Defecation Syndrome (ODS) consider as a complex disorder associated with structural and functional abnormalities of the pelvic floor. Our study aimed to evaluate radiology defecography findings in patients with ODS, determine the prevalence of structural and functional abnormalities, and assess the coexistence of these disorders in a retrospective cohort of 146 patients in our hospital. Methods: A retrospective study was conducted 146 patients who underwent fluoroscopic defecography between 2013 and 2025 with symptoms suggestive of Obstructed Defecation Syndrome (ODS). Demographic characteristics and defecographic findings were analyzed. Structural abnormalities, including rectocele, intussusception, rectal prolapse, enterocele, sigmoidocele, and megarectum, as well as functional abnormalities such as pelvic floor dyssynergia were evaluated. Data were analyzed using SPSS software and presented as frequencies, percentages, and descriptive statistics. Results: Abnormal defecographic findings were identified in the majority of patients. Rectocele was the most common abnormality, observed as an isolated finding in 15.1% of patients, while significant and minimal rectocele were detected in 6.8% and 3.4% of cases, respectively. Intussusception was present in 8.2% of patients and frequently coexisted with rectocele. Functional abnormalities, particularly pelvic floor dyssynergia, were also observed and commonly accompanied structural defects. Normal defecographic findings were reported in only 5.5% of patients, indicating a high diagnostic yield of defecography in the evaluation of ODS. Conclusion: Defecography provides a comprehensive assessment of Obstructed Defecation Syndrome by simultaneously evaluating structural and functional pelvic floor abnormalities. The frequent coexistence of these abnormalities highlights the importance of an integrated diagnostic approach and supports individualized management strategies for patients with ODS.

Keywords: Obstructed Defecation Syndrome, defecography, rectocele, intussusception, pelvic floor dyssynergia