No abstract

Background: Perineal descent syndrome is a disease that affects the pelvic floor because of denervation of its muscles, resulting in obstructed defecation. Hints on the anatomy that may be associated with the work got, and the physiology of the anorectum was explained, discussing factors leading to continence and mechanism of defecation was presented. Aim of work: to diagnose the perineal descent syndrome in both cases of chronic constipation and anal incontinence and usage of laparoscopy to treat PDS in children where the pathophysiological changes are known for each case and dealt with laparoscopically. Patient and Methods: This research was a forward-looking case study conducted during the period from June 2019 to June 2020 in the department of Pediatric Surgery, Al-Azhar university hospitals after approval by the Al Azhar Faculty of Medicine Ethical Review Committee. The research included 30 patients presented to the outpatient clinics with constipation or Fecal incontinence whom fulfilled the required Criteria. Results: In our study (n=30), 2 recurrent cases (13.3%) were found after laparoscopic suture rectopexy. Recurrence rates with mesh rectopexy or resection rectopexy was zero % and chronic constipation and fecal incontinence are considered as a hidden cause for perineal descent syndrome. Conclusion: The anterior rectal wall has a great dynamic role in defecation thanks to its viscoelastic properties. Any rectopexy technique should never interfere or impede this vital mechanism of action. Finally chronic constipation and fecal incontinence are considered as a hidden cause for perineal descent syndrome.