Pelvic floor dyssynergia refers to an acquired condition where, due to chronic constipation, the abdominal and pelvic floor muscles are no longer able to coordinate to affect a bowel movement. This happens due to the abdominal muscles distending while the pelvic floor muscles are contracting (or are unable to be relaxed), leading to ineffective pushing efforts. Pelvic floor dyssynergia falls into the Rome IV criteria of a functional defecation disorder.

Chronic constipation affects 11%-18% of the population, with a female-to-male ratio of almost 2:1. Of patients with chronic constipation, 25%-50% of them have pelvic floor issues. A significant number of patients will report having had issues since childhood. A history of sexual abuse and mood disorders also seem to be related to defecation difficulties.

Patients will present with complaints of difficulty passing stool, only passing small amounts of stool per sitting, incomplete emptying, infrequent bowel movements, a need for regular laxative use, and backache.

If this is chronic enough, some patients may have rectal incontinence as well. Patients may also report that they have to digitally evacuate stool.

Diagnostic criteria include having functional constipation symptoms for at least 12 weeks, evidence of dyssynergic pattern on defecography, and at least 2 other abnormal colorectal tests showing impaired evacuation.