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Background <p>Defecatory disorders and pelvic floor dysfunctions are prevalent and significantly impact quality of life. Due to their multifactorial etiology, a multidisciplinary approach and pelvic floor rehabilitation (PFR) are recommended; however, their implementation varies widely. This study aimed to evaluate current practices in multidisciplinary management and rehabilitation strategies for defecatory disorders in Italy.</p> Methods <p>A 25-item, web-based survey was distributed to members of the Italian Society of Colorectal Surgery between May and July 2024. The questionnaire explored the professional background of the responders, the availability and composition of the multidisciplinary team (MDT), and the use of PFR and related clinical practices.</p> Results <p>A total of 183 colorectal surgeons from 20 Italian regions completed the survey. Only 49% reported the presence of a structured MDT, with frequent absence of a urologist, gastroenterologist, and radiologist. Combined pelvic floor surgery was rarely performed, despite its clinical advantages. PFR services were available in just over half of the centers, often without psychological or nutritional support. Rehabilitative techniques varied, with volumetric rehabilitation and tibial nerve stimulation being underutilized. Referral rates to rehabilitation remained low, regardless of institution type or surgical experience. Despite the lack of standardized protocols, a quarter of responders utilized perioperative rehabilitation in the context of rectal prolapse surgery.</p> Conclusions <p>Significant variability exists in the multidisciplinary and rehabilitative management of defecatory disorders in Italy. To optimize care, greater integration of MDT, wider access to a standardized PFR, and the adoption of combined surgical approaches are needed.</p>

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Multidisciplinary approach and rehabilitation practice for defecatory disorders in Italy: a snapshot survey on behalf of the Italian Society of Colorectal Surgery (SICCR)

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  • 发表日期：

    2026年7月24日

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  • D. Zigiotto,
  • G. La Greca,
  • A. Elio,
  • G. A. Santoro,
  • S. Orlandi,
  • Alfonso Amendola,
  • Imerio Angriman,
  • Alfredo Annichiarico,
  • Laura Antolino,
  • Nicola Antonacci,
  • Simona Ascanelli,
  • Pasquale Ascenzi,
  • Giulia Bagaglini,
  • Andrea Balla,
  • Gianluca Baronio,
  • Paola Batistotti,
  • Marco Beggiato,
  • Vittoria Bellato,
  • Alex Bruno Bellocchia,
  • Luca Bonatti,
  • Andrea Bondurri,
  • Dario Bono,
  • Luca Domenico Bonomo,
  • Sebastiano Bonventre,
  • Alice Bressan,
  • Marco Brizzolari,
  • Tommaso Bruno,
  • Alberto Buonanno,
  • Danilo Cafaro,
  • Paola Campennì,
  • Giuseppe Candilio,
  • Alberto Carbone,
  • Fabio Carbone,
  • Stefano Carini,
  • Monica Carrera,
  • Francesco Carrino,
  • Antonio Castaldi,
  • Debora Cavallo,
  • Paola Cellerino,
  • Giovanni Cestaro,
  • Luca Cestino,
  • Antonella Chessa,
  • Gianpiero Cione,
  • Guglielmo Clarizia,
  • Marco Clementi,
  • Luigi Cobellis,
  • Francesco Colombo,
  • Andrea Comba,
  • Antonio Costanzo,
  • Michele Cricrì,
  • Fabrizio D’Acapito,
  • Ilaria D’Addea,
  • Sara D’Errico,
  • Giuliano D’Onghia,
  • Paola De Nardi,
  • Michele De Rosa,
  • Veronica De Simone,
  • Carmela Di Martino,
  • Daniela Di Pietrantonio,
  • Angelo Di Vittori,
  • Simona Deidda,
  • Daniele Delogu,
  • Antonino Di Sipio,
  • Nicolò Falco,
  • Ezio Falletto,
  • Raffaella Ferrando,
  • Federico Festa,
  • Giuseppe Fiducia,
  • Massimiliano Fiume,
  • Tommaso Fontana,
  • Lisa Fralleone,
  • Serena Fulginiti,
  • Giacomo Fuschillo,
  • Gaetano Gallo,
  • Francesco Ghiglione,
  • Mauro Giambusso,
  • Iacopo Giani,
  • Ivana Giannini,
  • Marta Goglia,
  • Gianpiero Gravante,
  • Giorgio Maria Paolo Graziano,
  • Ugo Grossi,
  • Claudio Guerci,
  • Silvio Guerriero,
  • Carlotta La Raja,
  • Andrea Lauretta,
  • Maria Lemma,
  • Giorgio Lisi,
  • Pierluigi Lobascio,
  • Luigi Losacco,
  • Antonio Luberto,
  • Enrico Lucci,
  • Mara Maccaferro,
  • Anna Maffioli,
  • Costantino Magnani,
  • Romina Manunza,
  • Carlo Alberto Manzo,
  • Fabio Marino,
  • Davide Mascali,
  • Gianluca Mascianà,
  • David Alessio Merlini,
  • Giovanni Milito,
  • Marco Milone,
  • Massimiliano Mistrangelo,
  • Iacopo Monaci,
  • Lorenzo Mori,
  • Andrea Morini,
  • Marta Mozzon,
  • Paolo Ossola,
  • Donato Paolo Pafundi,
  • Alessio Palumbo,
  • Federico Paniccia,
  • Gianmaria Casoni Pattacini,
  • Iole Pecori,
  • Luigi Pellecchia,
  • Roberto Peltrini,
  • Marianna Petrillo,
  • Francesco Pezzolla,
  • Arcangelo Picciariello,
  • Renato Pietroletti,
  • Federico Nicoletta Sveva Pipitone,
  • Marco Platto,
  • Giulia Poli,
  • Luca Pulzato,
  • Daniela Rega,
  • Marcella Rinaldi,
  • Lorenzo Ripamonti,
  • Valter Ripetti,
  • Salvatore Rizzo,
  • Giuseppe Rocco,
  • Francesco Romano,
  • Andrea Romanzi,
  • Michele Sacco,
  • Antonella Salvatore,
  • Alberto Sartori,
  • Francesco Selvaggi,
  • Vania Silvestri,
  • Elia Smerieri,
  • Giovanni Spiezio,
  • Antonino Spinelli,
  • Emanuela Stratta,
  • Andrea Marco Tamburini,
  • Nicolò Tamini,
  • Cinzia Tanda,
  • Gaetano Tessera,
  • Diran Timurian,
  • Giovanni Tomasicchio,
  • Paolo Tonello,
  • Nicola Tricomi,
  • Mario Trompetto,
  • Giulia Turri,
  • Roberta Tutino,
  • Antonella Usai,
  • Alessandro Ussia,
  • Marina Valente,
  • Paolo Veronesi,
  • Gabriele Viola,
  • Tommaso Violante,
  • Maurizio Zizzo,
  • Luigi Zorcolo

摘要

Background

Defecatory disorders and pelvic floor dysfunctions are prevalent and significantly impact quality of life. Due to their multifactorial etiology, a multidisciplinary approach and pelvic floor rehabilitation (PFR) are recommended; however, their implementation varies widely. This study aimed to evaluate current practices in multidisciplinary management and rehabilitation strategies for defecatory disorders in Italy.

Methods

A 25-item, web-based survey was distributed to members of the Italian Society of Colorectal Surgery between May and July 2024. The questionnaire explored the professional background of the responders, the availability and composition of the multidisciplinary team (MDT), and the use of PFR and related clinical practices.

Results

A total of 183 colorectal surgeons from 20 Italian regions completed the survey. Only 49% reported the presence of a structured MDT, with frequent absence of a urologist, gastroenterologist, and radiologist. Combined pelvic floor surgery was rarely performed, despite its clinical advantages. PFR services were available in just over half of the centers, often without psychological or nutritional support. Rehabilitative techniques varied, with volumetric rehabilitation and tibial nerve stimulation being underutilized. Referral rates to rehabilitation remained low, regardless of institution type or surgical experience. Despite the lack of standardized protocols, a quarter of responders utilized perioperative rehabilitation in the context of rectal prolapse surgery.

Conclusions

Significant variability exists in the multidisciplinary and rehabilitative management of defecatory disorders in Italy. To optimize care, greater integration of MDT, wider access to a standardized PFR, and the adoption of combined surgical approaches are needed.