Optimizing diagnosis in obstructed defecation syndrome: A review of imaging modalities

Authors

Jai P. SinghFollow
Shayan Assaie-Ardakany, Henry Ford HealthFollow
Maryam A. Aleissa, Henry Ford Health
Kareem Al-Shaer
Gautham Chitragari, Henry Ford HealthFollow
Ernesto R. Drelichman, Henry Ford HealthFollow
Vijay K. Mittal, Henry Ford HealthFollow
Jasneet S. Bhullar, Henry Ford HealthFollow

Recommended Citation

Singh JP, Assaie-Ardakany S, Aleissa MA, Al-Shaer K, Chitragari G, Drelichman ER, Mittal VK, and Bhullar JS. Optimizing diagnosis in obstructed defecation syndrome: A review of imaging modalities. World J Radiol 2025;17(7):107459.

Document Type

Article

Publication Date

7-28-2025

Publication Title

World J Radiol

Abstract

Obstructed defecation syndrome (ODS) is a complex defecatory disorder associated with pelvic floor dysfunction. It affects approximately 50% of women over the age of 50 and significantly impacts their quality of life. The causes of ODS include structural abnormalities such as rectocele, enterocele, intussusception, and pelvic floor descent, as well as functional disorders like anismus. Accurate diagnosis is crucial for effective management due to the high risk of treatment failure associated with inaccurate findings. Various imaging modalities are used to assess pelvic floor disorders, including fluoroscopic defecography (FD), magnetic resonance defecography (MRD), pelvic floor ultrasound (PFUS), and echodefecography (EDF). FD is the most commonly performed test worldwide, offering high accuracy in diagnosing pelvic floor disorders. It provides dynamic visualization of defecation mechanics but involves radiation exposure. MRD offers excellent soft tissue detail and multiplanar imaging without radiation, making it particularly useful for multicompartment disorders; however, it is associated with high procedural costs and limited availability. Both PFUS and EDF are minimally invasive and avoid radiation exposure. PFUS shows promise as a valuable screening tool that could help minimize the need for advanced imaging if findings are normal. EDF is also promising but requires specialized training and remains less widely available. This review evaluates the accuracy, advantages, and limitations of various diagnostic modalities for pelvic floor disorders, aiming to guide optimal clinical decision-making.

Medical Subject Headings

Anismus; Defecography; Echodefecography; Intussusception; MR defecography; Pelvic floor disorders; Pelvic floor ultrasound; Rectocele

PubMed ID

40746517

Volume

17

Issue

7

First Page

107459

Last Page

107459