Abstract
Introduction and hypothesis
The objective was to characterize postoperative bowel symptoms in women undergoing vaginal prolapse reconstructive surgery randomized to preoperative bowel preparation vs a regular diet.
Methods
Subjects (N = 121) completed two bowel diaries: a 7-day bowel diary immediately before surgery and a 14-day diary postoperatively. Self-reported bowel diary data and symptoms included the time to first bowel movement (BM), daily number of BMs, Bristol Stool Form Scale score, pain, and urgency associated with BM, episodes of fecal incontinence, and use of laxatives. Antiemetic use was abstracted from medical records. Outcomes of groups were compared using Chi-squared/Fisher’s exact test or Student’s t test as appropriate.
Results
Mean time to first postoperative BM was similar in the bowel preparation (n = 60) and control groups (n = 61), 81.2 ± 28.9 vs 78.6 ± 28.2 h, p = 0.85. With the first BM, there were no significant differences between bowel preparation and control groups regarding pain (17.2 vs 27.9 %, p = 0.17), fecal urgency with defecation (56.9 vs 52.5 %, p = 0.63), fecal incontinence (14.0 vs 15.0 %, p = 0.88) and >1 use of laxatives (93.3 vs 96.7 % p = 0.44) respectively. Antiemetic use was similar in both groups (48.3 vs 55.7 % respectively, p = 0.42).
Conclusions
There were no differences in the return of bowel function and other bowel symptoms postoperatively between the randomized groups. Lack of bowel preparation does not have an impact on the risk of painful defecation postoperatively. This information may be used to inform patients regarding expectations for bowel function after vaginal reconstructive surgery.
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Conflict of interest
None of the authors has any conflicts of interest.
Author participation
A. Ballard: concept development, data collection, manuscript draft/edit/final approval; C. Parker-Autry: data collection and manuscript draft/edit/final approval; C.P. Lin: analysis of data and manuscript draft/edit/final approval; A. Markland: concept development, data collection, manuscript draft/edit/final approval; D. Ellington: data collection and manuscript draft/edit/final approval; H. Richter: concept development and manuscript draft/edit/final approval.
Funding source
University of Alabama at Birmingham, Division of Urogynecology and Pelvic Reconstructive Surgery; partially supported by the National Institute of Diabetes and Digestive and Kidney Diseases 2K24-DK068389 to H. Richter.
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Registration: www.clinicaltrials.gov (NCT01431040)
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Ballard, A., Parker-Autry, C., Lin, C.P. et al. Postoperative bowel function, symptoms, and habits in women after vaginal reconstructive surgery. Int Urogynecol J 26, 817–821 (2015). https://doi.org/10.1007/s00192-015-2634-8
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DOI: https://doi.org/10.1007/s00192-015-2634-8