Anorectal disorders following pelvic organ prolapse surgery

Functional disorders of defecation (constipation, obstructive defecation syndrome, faucal incontinence) are common in women presenting with pelvic organ prolapse. However, very few data are available concerning de novo anorectal disorders following pelvic organ prolapse surgery. Evaluation includes detailed history and rectal and pelvic exam, together with physiologic tests such as anorectal manometry, balloon expulsion test, defecography, and pelvic MRI. De novo constipation is reported up to 26% in women who have undergone abdominal sacrocolpopexy and ranges from 5% to 19% in women who have undergone a laparos- copic sacrocolpopexy. The prevalence of de novo obstructed defecation syndrome ranges from 2% to 4% in women who have undergone laparoscopic sacrocolpopexy or for whom a synthetic polypropylene mesh was placed by vaginal route. Finally, the prevalence of de novo anorectal disorders is not rare following pelvic organ prolapse surgery and patients should be informed preoperatively.