Obstructed defecation syndrome (ODS) affects a large percentage of women in their mid-to-late 40s and 50s. These symptoms, together with the requirement for digital vaginal or perineal help, incomplete evacuation, excessive straining during defecation, and the necessity for enemas or suppositories to eliminate waste, may have a negative impact on the quality of life for many people. Stapled Trans Anal Rectal Resection (STARR) is a novel surgical method that allows for circumferential removal of the anorectal full thickness wall and reinforcement of the anorectal junction using two circular staplers. Antonio Longo’s surgical approach was presented as an alternate therapy for ODS.
More than 30% of individuals with ODS improved with diet and biofeedback therapy; moreover, conservative therapy may prevent unrequired and perhaps harmful surgery in these patients. Structural anomalies should only need surgery in individuals who are unable to respond to conservative therapy.
The pathogenesis of ODS is still a mystery, making it a difficult clinical condition to treat.
Rectocele and rectal intussusceptions are both treated with the STARR surgery. With both rectal mucous prolapse and rectocele, traditional surgeries have a significant incidence of delayed healing and dyspareunia in the perineal incision. ODS patients now have a less intrusive option in the form of STARR after it was successfully tested.
Technically, the STARR procedure for the management of ODS is very simple and can revert all constipation symptoms; the operative time and hospital stay were short, the postoperative pain and bleeding were minimal, there was no sepsis or postoperative dyspareunia, and patients returned early to work. There were no complications. The STARR technique for the treatment of ODS has been shown safe and effective in several investigations.
It is safe and successful for the treatment of blocked defecation syndrome caused due to rectal intussusception and/or rectocele, and may be done without severe morbidity.