History Taking in patients with suspected ODS should include questions about: Defaecation frequency, ease or difficulty of evacuation, sensation of pelvic fullness, sensation of incomplete emptying, straining, urgency & faecal incontinence as well as urinary [difficulty, incontinence] & sexual symptoms [bulge, incontinence during intercourse]

Symptoms may be classfied into one of 4 categories:

A. Symptoms related to the act of Defaecation:

Straining excessively to achieve defaecation

Inability to initiate defaecation despite multiple attempts

Feeling of incomplete emptying after defaecation

Feeling the need to go again shortly after first attempt is completed, resulting in opening bowels several times e.g. in the morning “Interrupted Defaecation”

Urgency

Passive faecal leakage after defaecation [not occurring if no defaecation occurred that day]

History of use of enemas, laxatives or manual dis-impaction

History of using fingers to help evacuation [in the vagina or anus]

History of using perineal pressure to help evacuation

B. Symptoms related to prolapse:

Mucous discharge

Sense of prolapse / organs falling down

Feeling a vaginal bulge during intercourse

C. Deep seated pelvic discomfort / pain:

Sitting on an egg / orange ”something inside”

D. Other "associated" Symptoms:

Stress urinary incontinence

Uterine prolapse