Solitary rectal prolapse and concomitant genital prolapse: Classification and new surgical therapy        Antonio Longo. Department of Coloproctology and Pelvic Diseases, Via Maqueda. 8, 90134 Palermo, Italy
Abstract    Constipation is a pathology in which there are many confusing definitions. The ITT (Intestinal Transit Time) is not an absolute and constant value, highly variable, even in the same person. It is often a consequence of obstructed defecation syndrome (ODS) and not a primary cause of constipation. Patients with pelvic dyssynergia (PD) increase the abdominal strain, in an attempt to increase the endopelvic pressure to create the defecation stimulus. It would lead to dynamic to anatomical alterations as following: perineum hyperdescending, the Douglas pouch deepening or an enterocele occurrence, the rectum and bladder dilating towards the vagina, uterine and vaginal prolapse, etc. With the stapled transanal rectal resection (STARR) technique, pre and postoperative dynamic defecography show the regression of such alterations.