Laparoscopic Ventral Mesh Rectopexy Combined With or Without Stapled Trans-anal Rectal Resection for Obstructed Defecation Syndrome

Inclusion Criteria: * Patients affected by obstructed defecation with a minimum ODS score of 10 * External rectal prolapse or high-grade internal rectal prolapse * 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 * Failure of at least 6 months of medical therapy * American Society of Anesthesiologists (ASA) score of no more than 3 Exclusion Criteria: * Slow transit constipation * Anismus resistant to conventional treatment * No demonstrable pelvic anatomical problem * Previous rectal or anal surgery * Recto-vaginal fistula * Pregnancy * Previous pelvic radiotherapy * Severe proctitis or significant rectal fibrosis * Evidence of colorectal neoplasia, carcinoma, or inflammatory bowel disease * Perineal infection * High-grade endometriosis * Morbid obesity * A hostile abdomen * Psychological instability