Study of Stapled Transanal Rectal Resection (STARR) Surgery in Refractory Constipation Associated With Obstructive Defecation Syndrome (ODS)

Inclusion Criteria: * Able to comprehend, understand, and speak the English language * Able to comprehend, follow, and sign an informed consent document (ICD) * Able to tolerate general or spinal anesthetic * Often experience excessive straining, sense of incomplete evacuation, and/or prolonged time for complete evacuation when attempting a bowel movement * Have experienced ODS symptoms for at least 12 months prior to enrollment * Have a minimum ODS score of 10 * Have rectocele and/or rectal intussusception confirmed by defecography * Screened for colorectal neoplasia within 7 years of the screening visit (e.g., colonoscopy or barium enema) * Have an American Society of Anesthesiologists (ASA) score of no more than 3 * Willing to comply with evaluation and management schedule through 5-year follow-up Exclusion Criteria: * Fecal incontinence to solid stool * Full-thickness prolapse * Perineal infection * Recto-vaginal fistula * Enterocele (at rest) * Any complex pelvic floor prolapse requiring a combined surgical approach * Prior sigmoid or anterior resection or prior rectal anastomosis * Presence of foreign material adjacent to the rectum (e.g., vaginal mesh) * Grade IV hemorrhoids * Pregnancy * Chronic narcotic use * Evidence of colorectal neoplasia, carcinoma, or inflammatory bowel disease * Physical or psychological condition which would impair study participation * Unable or unwilling to attend follow-up visits and examinations * Surgical procedure required concurrentl…