Individual obstructed defaecation symptom components of the Wexner constipation score and their response to anti-prolapse surgery: LTP48

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Aim:Obstructed defaecation is a syndrome consisting of a cluster of symptoms associated with evacuatory dysfunction. We aimed to assess which individual symptoms before and after ventral rectopexy.Method:Data on patients from aprospective pelvic floor database were analysed. Individual symptom components of the Wexner constipation score excluding duration were assessed before and after laparoscopic ventral rectopexy.for high-grade (Oxford Prolapse Grade 3/4) internal rectalprolapse. Data were expressed aspreop mean scores (range 0-4) and post-op:pre-op ratio.Results:One hundred and seventy patients underwent laparoscopic ventral rectopexy. Pre-op scores [and post-op ratios] in descending order were: incomplete evacuation 3.22 [0.53]; assisted defaecation 2.52 [0.44]; abdominal pain 1.97 [0.52]; anorectal pain 1.87 [0.55]; toilet time 1.35 [0.51]; toilet revisiting 1.34 [0.60]; stool frequency 0.34 [0.65]. Six symptom pairs were significantly correlated (P < 0.05).Conclusion:Individual symptoms were highly correlated. The Wexner score improvedproportionally with rectopexy, less so for those with lowerpre-op symptom load.

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