Original
Outcomes of Internal Delorme’s Procedure in the Treatment for Obstructed Defecation Syndrome Caused by Rectal Intussusception
*Yesmin F,1 Sheikh MSH,2 Islam MS,3 Siddique MA,4 Siddique AB5
- *Dr. Farhana Yesmin, Assistant Professor, Department of Oncosurgery, National Institute of Cancer Research & Hospital (NICRH), Mohakhali, Dhaka. rehanasfiya152@gmail.com. ORCID: https://orcid.org/0009-0000-7342-0338
- Dr. Md. Shahadot Hossain Sheikh, Professor, Department of Colorectal Surgery, Bangladesh Medical University (BMU). ORCID: https://orcid.org/0009-0009-1422-3321
- Dr. Md. Shahidul Islam, Associate Professor, Department of Colorectal Surgery, Bangladesh Medical University (BMU). ORCID: https://orcid.org/0009-0008-0554-4636
- Dr. Muhammad Ali Siddique, Associate Professor, Department of Colorectal Surgery, Bangladesh Medical University (BMU). ORCID: http://orcid.org/0009-0000-2355-4156
- D r. Abu Bakar Siddique, Associate Professor, Department of Urology, Dhaka Medical College Hospital, Dhaka. ORCID: http://orcid.org/0009-0007-7940-0304
*For correspondence
Abstract
Background: Obstructed defecation syndrome (ODS) is a complex functional & anatomical disorder compelling patient to exhausting ineffective attempts to defecate and Rectal Intussusception is one of the most common causes of ODS which needs surgical intervention with different procedures after conservative treatment fail. Internal Delorme’s procedure would be a good alternative for treating ODS due to its less postoperative complications with excellent functional results and patient’s satisfaction and better than any other more expensive and invasive techniques used for this condition.
Objectives: To evaluate the effectiveness and safety of the endorectal proctopexy (internal delorme’s) in the treatment of ODS secondary to Rectal Intussusception.
Methods: This Observational study was conducted in the Department of Colorectal Surgery, Bangladesh Medical University, Dhaka from January 2024 to December, 2024. All patients with ODS refractory to non-operative treatment were included in this study following the inclusion and exclusion criteria. Informed written consent was obtained after explaining the details of the procedure. Then, the patient’s preoperative status, perioperative complications and postoperative outcomes were recorded to evaluate constipation by Modified Longo ODS score. All parameters and variables were analyzed in a pre-designed SPSS data sheet.
Results: The study included 25 participants (mean age 34.88 ± 16.18 years; 48% ≤30 years), with a female predominance (64%) and mean BMI of 24.13 ± 3.21 kg/m². Major symptoms included incomplete evacuation and straining (96%), assisted evacuation (80%), per-rectal bleeding (76%), and repeated toilet visits (72%). Mean symptom duration was 13.24 ± 4.11months ranging from 2 to 20 months. Grade III rectal prolapse was most frequent in 21 (84%), followed by Grade IV in 4(16%). Rectocele was associated with rectal intussusception in 14 (56%) with moderate rectocele observed in 7(50%), mild in 5 (35.7%), and severe in 2 (14.3%). Partial utero-vaginal prolapse occurred in 8(50%), Cystocele and pelvic floor descent were present in minor group of patients 2 (12.5%) of each. Only 3(12%) received Bio-feedback therapy preoperatively but there was no success in symptoms improvement without surgery. Urinary retention (24%) was the most common post-operative complication. Recurrence occurred in 2(8%). Mean operative time was 111.92 ± 16.40 minutes, and hospital stay averaged 2.80 ± 0.58 days. The mean ODS score improved significantly from 14.72 ± 3.13 pre-operatively to 4.44 ± 1.00 at 3 months and 3.56 ± 0.82 at 6 months (p < 0.001), demonstrating substantial and sustained symptom relief.
Conclusion:. IDP showing considerable obstructive symptoms reduction about 75.8% with short hospital stay, low recurrence (8%) and some manageable perioperative complications. So, it appeared to be safe and effective with a successful outcome in most of the ODS patients.
[Shaheed Syed Nazrul Islam Med Col J 2026, July; 11 (2):234-241]
DOI: https://www.doi.org/10.69699/ssnimcj.2026.11.2.17