A Case of Refractory Functional Defecation Disorder （Dyssynergic Defecation） Constipation Leading to Surgical Treatment

Conservative treatment such as biofeedback therapy is considered to be useful for functional defecation disorder （ dyssynergic defecation ） , but the indications for surgery are not clear. In this study, we report a case of surgical bowel resection in a 71-year-old woman with dyssynergic defecation who did not respond to conservative treatment and had a markedly decreased QOL. The patient was a 71-year-old woman who was admitted to the hospital for examination and treatment of dyssynergic defecation and marked abdominal distension for 10 years. Defecography showed no fecal discharge, and a colonic transit time test showed that the opacity marker had reached the rectum after 24 hours. After 3 months of conservative treatment, no improvement was observed, and a transverse loop colostomy was performed. However, stomal prolapse was observed postoperatively, the patient underwent laparoscopic resection of the left side colon, rectum, and transverse end colostomy. The patient and her family were highly satisfied with the good discharge of stool from the stoma. We believe that improv-ing the patient ʼ s QOL should be the first priority, and that the surgical technique should be selected according to the indi-vidual case.