Multidisciplinary approach and rehabilitation practice for defecatory disorders in Italy: a snapshot survey on behalf of the Italian Society of Colorectal Surgery (SICCR)

Defecatory disorders and pelvic floor dysfunctions are prevalent and significantly impact quality of life. Due to their multifactorial etiology, a multidisciplinary approach and pelvic floor rehabilitation (PFR) are recommended; however, their implementation varies widely. This study aimed to evaluate current practices in multidisciplinary management and rehabilitation strategies for defecatory disorders in Italy. A 25-item, web-based survey was distributed to members of the Italian Society of Colorectal Surgery between May and July 2024. The questionnaire explored the professional background of the responders, the availability and composition of the multidisciplinary team (MDT), and the use of PFR and related clinical practices. A total of 183 colorectal surgeons from 20 Italian regions completed the survey. Only 49% reported the presence of a structured MDT, with frequent absence of a urologist, gastroenterologist, and radiologist. Combined pelvic floor surgery was rarely performed, despite its clinical advantages. PFR services were available in just over half of the centers, often without psychological or nutritional support. Rehabilitative techniques varied, with volumetric rehabilitation and tibial nerve stimulation being underutilized. Referral rates to rehabilitation remained low, regardless of institution type or surgical experience. Despite the lack of standardized protocols, a quarter of responders utilized perioperative rehabilitation in the context of rectal prolapse surgery. Significant variability exists in the multidisciplinary and rehabilitative management of defecatory disorders in Italy. To optimize care, greater integration of MDT, wider access to a standardized PFR, and the adoption of combined surgical approaches are needed.

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Publication Details

Journal
Techniques in Coloproctology
Published
2026-07-24
DOI
https://doi.org/10.1007/s10151-026-03294-9
Primary Topic
Pelvic floor disorders treatments
Type
article
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article

Multidisciplinary approach and rehabilitation practice for defecatory disorders in Italy: a snapshot survey on behalf of the Italian Society of Colorectal Surgery (SICCR)

Silvio Guerriero, Giorgio Maria Paolo Graziano, Ilaria D’Addea, Luca Bonatti et al.
Techniques in Coloproctology
Pelvic floor disorders treatments
article

Multidisciplinary approach and rehabilitation practice for defecatory disorders in Italy: a snapshot survey on behalf of the Italian Society of Colorectal Surgery (SICCR)

Silvio Guerriero, Giorgio Maria Paolo Graziano, Ilaria D’Addea, Luca Bonatti, Giulia Bagaglini, Angelo Di Vittori, Danilo Cafaro, L Bonomo, Marco Brizzolari, Luca Cestino, Ezio Falletto, Ivana Giannini, Romina Manunza, Mauro Giambusso, G Fiducia, Antonio Luberto, Marta Goglia, Francesco Colombo, Michele Cricrì, Fabio Carbone, P Cellerino, T Bruno, Ugo Grossi, A Costanzo, Daniela Di Pietrantonio, Paola Campennì, Davide Mascali, A. Amendola, Monica Carrera, Nicola Antonacci, Daniele Zigiotto, Vittoria Bellato, Debora CAVALLO, Sara D’Errico, Pierluigi Lobascio, Tommaso Fontana, Antonio Castaldi, Andrea Balla, Lisa Fralleone, Anna Maffioli, Daniele Delogu, L. Losacco, Carlo Alberto Manzo, Claudio Guerci, Stefano Carini, Simona Deidda, Fabrizio D’Acapito, Giuseppe Candilio, A Chessa, Carlotta La Raja, Francesco Ghiglione, Alice Bressan, Giacomo Fuschillo, G Baronio, Andrea Lauretta, Francesco Carrino, Carmela Di Martino, Alex Bruno Bellocchia, Maria Lemma, Giorgio Lisi, Laura Antolino, Andrea Comba, Guglielmo Clarizia, Nicolò Falco, Giulio Aniello Santoro, Imerio Angriman, Fabio Marino, Sebastiano Bonventre, Paola Batistotti, Marco Beggiato, P Ascenzi, A. Elio, Giovanni Cestaro, Giuliano D’Onghia, Enrico Lucci, Federico Festa, Alfredo Annichiarico, Serena Fulginiti, Dario Bono, M Fiume, Luigi Cobellis, Raffaella Ferrando, Costantino Magnani, Paola De Nardi, Andrea Bondurri, Simona Ascanelli, Alberto Buonanno, Marco Clementi, S. Orlandi, G. La Greca, Gianpiero Gravante, Mara Maccaferro, Pelvic Floor Rehabilitation Group, Alberto Carbone, Michele De Rosa, Veronica De Simone, Iacopo Giani, Gianpiero Cione, Antonino Di Sipio, Gaetano Gallo
article en

Abstract

Defecatory disorders and pelvic floor dysfunctions are prevalent and significantly impact quality of life. Due to their multifactorial etiology, a multidisciplinary approach and pelvic floor rehabilitation (PFR) are recommended; however, their implementation varies widely. This study aimed to evaluate current practices in multidisciplinary management and rehabilitation strategies for defecatory disorders in Italy. A 25-item, web-based survey was distributed to members of the Italian Society of Colorectal Surgery between May and July 2024. The questionnaire explored the professional background of the responders, the availability and composition of the multidisciplinary team (MDT), and the use of PFR and related clinical practices. A total of 183 colorectal surgeons from 20 Italian regions completed the survey. Only 49% reported the presence of a structured MDT, with frequent absence of a urologist, gastroenterologist, and radiologist. Combined pelvic floor surgery was rarely performed, despite its clinical advantages. PFR services were available in just over half of the centers, often without psychological or nutritional support. Rehabilitative techniques varied, with volumetric rehabilitation and tibial nerve stimulation being underutilized. Referral rates to rehabilitation remained low, regardless of institution type or surgical experience. Despite the lack of standardized protocols, a quarter of responders utilized perioperative rehabilitation in the context of rectal prolapse surgery. Significant variability exists in the multidisciplinary and rehabilitative management of defecatory disorders in Italy. To optimize care, greater integration of MDT, wider access to a standardized PFR, and the adoption of combined surgical approaches are needed.

Techniques in Coloproctology
IRCCS Policlinico San Donato (IT), Ospedale Sacro Cuore Don Calabria (IT), Humanitas Castelli (IT), Humanitas Gavazzeni (IT)
Zero hunger
Openalex Percentile: Top 8%
Pelvic floor disorders treatments
DOIOpen Access PDFOpenAlex
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