Outcomes of Internal Delorme’s Procedure in the treatment for Obstructed Defecation Syndrome caused by Rectal intussusception and Rectocele

Introduction: Obstructed defecation syndrome (ODS) is a complex functional & anatomical disorder compelling patient to exhausting ineffective attempts to defecate and Rectal Intussusception and Rectocele are the common structural causes which need surgical intervention to address the underlying anatomical deformity. This study aimed to assess the effectiveness and safety of the Internal Delorme’s procedure in the treatment of ODS caused by Rectal Intussusception and Rectocele. 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 nonoperative treatment were included in this study following the inclusion and exclusion criteria.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. 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: Internal Delorme’s procedure is an effective surgical procedure for treating ODS secondary to rectal intussusception and rectocele with significant and lasting improvement in defecatory function. Medicine Today 2026, Vol.38 (2): 163-167