الفهرس 
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Abstract
Obstructed defecation syndrome (ODS) is characterized by the presence of bulky stools, feeling of inadequate emptying, feeling of blockage during passage of stools, and/or difficulty in defecation without manual assistance.(1) ODS is a frequently encountered complex disorder with multiple contributing factors, where individuals experience difficulty in evacuation despite having the normal urge for it. It typically involves prolonged and strenuous efforts and often requires manual support and manipulation of the perineal area to aid in defecation. (2, 3)
Obstructed defecation syndrome (ODS) is caused by a complex of anatomical and functional disorders that lead to difficult and inadequate rectal emptying. It is frequently observed in women in their middle age who gave birth multiple times. The prevalence of this condition in the general population is 3.4% and reaches up to 23% in middle-aged women. It is considered one of the forms of constipation. There are generally two main categories into which constipation can be broadly classified: primary functional constipation or secondary constipation that arises as a result of systemic disorders. Primary functional constipation can be: colonic inertia (also known as slow transit constipation or STC), constipation-predominant irritable bowel syndrome, or obstructed defecation syndrome (ODS). (2-4)
ODS is classified as an evacuation disorder and distinguishes itself from STC due to the fact that, in cases presenting only with ODS, there is no delay for the faeces to reach the rectum. However, in almost 30% of patients, both conditions manifest simultaneously, necessitating a specialized evaluation of the pelvic floor in order to distinguish between the two disorders, as their treatment approaches vary significantly.(4)
According to ROME III criteria, the following criteria should be present for at least 3 months to diagnose ODS:
1. Two or more of the following symptoms in at least 25% of defecations:
(a) Straining,
(b) Bulky stools,