Descending perineum syndrome

Descending perineum syndrome (DPS) is a condition characterized by a lower than normal position of the perineum at rest and/or on straining, often associated with symptoms of obstructed defecation. It was first described by Parks et al. in 1966.

Etiology

The exact cause of DPS is not known. However, it is believed to be associated with chronic straining during defecation, chronic constipation, and childbirth. Pelvic floor dysfunction and rectal prolapse are also associated with DPS.

Symptoms

The most common symptom of DPS is a sensation of incomplete evacuation after defecation. Other symptoms may include straining during defecation, need for digital evacuation, and pelvic pain. Some patients may also experience urinary symptoms such as urgency and frequency.

Diagnosis

Diagnosis of DPS is primarily based on clinical history and physical examination. Additional tests such as defecography, anorectal manometry, and pelvic floor MRI may be used to confirm the diagnosis and rule out other conditions.

Treatment

Treatment of DPS is primarily conservative and includes dietary modifications, pelvic floor physiotherapy, and biofeedback. In severe cases, surgery may be required.

See also

• Pelvic floor dysfunction
• Rectal prolapse
• Constipation