Singh JP, Assaie-Ardakany S, Aleissa MA, Al-Shaer K, Chitragari G, Drelichman ER, Mittal VK, Bhullar JS. Optimizing diagnosis in obstructed defecation syndrome: A review of imaging modalities. World J Radiol 2025; 17(7): 107459 [DOI: 10.4329/wjr.v17.i7.107459]
Corresponding Author of This Article
Jai P Singh, Department of Surgery, Henry Ford Providence Hospital, Michigan State University College of Human Medicine, 16001 W Nine Mile Road, Southfield, MI 48075, United States. drjp04@gmail.com
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Radiol. Jul 28, 2025; 17(7): 107459 Published online Jul 28, 2025. doi: 10.4329/wjr.v17.i7.107459
Optimizing diagnosis in obstructed defecation syndrome: A review of imaging modalities
Jai P Singh, Shayan Assaie-Ardakany, Maryam A Aleissa, Kareem Al-Shaer, Gautham Chitragari, Ernesto R Drelichman, Vijay K Mittal, Jasneet S Bhullar
Jai P Singh, Shayan Assaie-Ardakany, Maryam A Aleissa, Gautham Chitragari, Ernesto R Drelichman, Vijay K Mittal, Jasneet S Bhullar, Department of Surgery, Henry Ford Providence Hospital, Michigan State University College of Human Medicine, Southfield, MI 48075, United States
Kareem Al-Shaer, Department of Biological Science, Wayne State University, Detroit, MI 48202, United States
Co-corresponding authors: Jai P Singh and Jasneet S Bhullar.
Author contributions: Singh JP wrote the manuscript; Assaie-Ardakany S, Aleissa MA, Al-Shaer K, Chitragari G, Drelichman ER, and Mittal VK assisted in writing the manuscript; Bhullar JS designed research, wrote the paper; Singh JP is the primary author, has undertaken the majority of the research work, including designing the paper, reviewing resources, and manuscript preparation. Singh JP serves as the primary corresponding author and has led the majority of the research efforts, including study design, resource review, and manuscript preparation. He is responsible for all communication with the journal, overseeing the submission process, and addressing editorial and reviewer feedback. Bhullar JS is designated as the senior corresponding author. He will be available to respond to reader inquiries, drawing on his extensive expertise to provide detailed insights and perspectives. We believe this dual corresponding author arrangement will facilitate clear, efficient communication with the journal and support meaningful engagement with the wider research community.
Conflict-of-interest statement: The authors have no relevant financial or non-financial interests to disclose.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jai P Singh, Department of Surgery, Henry Ford Providence Hospital, Michigan State University College of Human Medicine, 16001 W Nine Mile Road, Southfield, MI 48075, United States. drjp04@gmail.com
Received: March 25, 2025 Revised: May 6, 2025 Accepted: July 1, 2025 Published online: July 28, 2025 Processing time: 123 Days and 7.6 Hours
Abstract
Obstructed defecation syndrome (ODS) is a complex defecatory disorder associated with pelvic floor dysfunction. It affects approximately 50% of women over the age of 50 and significantly impacts their quality of life. The causes of ODS include structural abnormalities such as rectocele, enterocele, intussusception, and pelvic floor descent, as well as functional disorders like anismus. Accurate diagnosis is crucial for effective management due to the high risk of treatment failure associated with inaccurate findings. Various imaging modalities are used to assess pelvic floor disorders, including fluoroscopic defecography (FD), magnetic resonance defecography (MRD), pelvic floor ultrasound (PFUS), and echodefecography (EDF). FD is the most commonly performed test worldwide, offering high accuracy in diagnosing pelvic floor disorders. It provides dynamic visualization of defecation mechanics but involves radiation exposure. MRD offers excellent soft tissue detail and multiplanar imaging without radiation, making it particularly useful for multicompartment disorders; however, it is associated with high procedural costs and limited availability. Both PFUS and EDF are minimally invasive and avoid radiation exposure. PFUS shows promise as a valuable screening tool that could help minimize the need for advanced imaging if findings are normal. EDF is also promising but requires specialized training and remains less widely available. This review evaluates the accuracy, advantages, and limitations of various diagnostic modalities for pelvic floor disorders, aiming to guide optimal clinical decision-making.
Core Tip: This article reviews the role of various imaging modalities in evaluating pelvic floor disorders, which affect approximately 50% of women aged 50 and older. Accurate diagnosis is crucial for effective management, as undetected abnormalities can lead to a high rate of treatment failure. Through a comparative analysis of different imaging techniques, this article seeks to provide insights that can help guide more informed management strategies for pelvic floor disorders.
