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AIM: To compare defecographic abnormalities in symptomatic men and women and to analyze differences between men and age- and symptom-matched women.METHODS: Sixty-six men (mean age: 55.4 years,range: 20-81 years) who complained of constipation and/or fecal incontinence and/or pelvic pain underwent defecography after intake of a barium meal. Radiographs were analyzed for the diagnosis of rectocele, enterocele,intussusception and perineal descent. They were compared with age- and symptom-matched women ( n = 198) who underwent defecography during the same period.RESULTS: Normal defecography was observed in 22.7% of men vs 5.5% of women ( P < 0.001). Defecography in men compared with women showed 4.5%vs 44.4% ( P < 0.001) rectocele, and 10.6% vs 29.8%( P < 0.001) enterocele, respectively. No difference was observed for the diagnosis of intussusception (57.6% vs 44.9%). Perineal descent at rest was more frequent in women ( P < 0.005).CONCLUSION: For the same complaint, diagnosis of defecographic abnormalities was different in men than in women: rectocele, enterocele and perineal descent at rest were observed less frequently in men than in women.