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Effect of hysterectomy on bowel function

  • Original Contributions
  • Diseases of the Colon & Rectum
  • Published:
Diseases of the Colon & Rectum

Abstract

Purpose: Hysterectomy is the most common major gynecologic procedure. Unwanted postoperative effects on bowel function are a topic of recent debate. The aim of the present study was to prospectively evaluate the influence of hysterectomy on bowel function. Methods: One hundred and twenty consecutive patients undergoing hysterectomy for benign conditions answered a questionnaire covering bowel habits and symptoms preoperatively and at 6 and 12 months postoperatively. Forty-four patients underwent vaginal hysterectomy and 76 underwent abdominal hysterectomy. Concomitant bilateral salpingo-oopherectomy was performed in 17 patients. Results: After abdominal hysterectomy, patients reported increased symptoms of gas incontinence, urge to defecate, and inability to distinguish between gas and feces (P < 0. 05). There was a tendency of increased fecal incontinence. Subgroup analysis indicated that concomitant bilateral salpingo-oopherectomy resulted in an increased risk of fecal incontinence. No significant changes were detected in symptoms associated with constipation. Mean defecation frequency increased and the frequency of pelvic heaviness symptoms was reduced. After vaginal hysterectomy, there was no increased frequency of incontinence or constipation symptoms. The frequency of pelvic heaviness symptoms was reduced. Conclusions: Patients undergoing abdominal hysterectomy may run an increased risk for developing mild to moderate anal incontinence postoperatively and this risk is increased by simultaneous bilateral salpingo-oopherectomy. An increased risk of anal incontience symptoms could not be identified in patients undergoing vaginal hysterectomy. Our study does not support the assumption that hysterectomy is associated with de novo or deteriorating constipation.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Karolinska Institutet Danderyd Hospital, Stockholm, Sweden

    Daniel Altman, Jan Zetterström & Annika López

  2. Department of Surgery, Karolinska Institutet Danderyd Hospital, Stockholm, Sweden

    Johan Pollack, Johan Nordenstam & Anders Mellgren

  3. Department of Colon and Rectal Surgery, University of Minnesota, Minneapolis, Minnesota, USA

    Anders Mellgren

Authors
  1. Daniel Altman
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  2. Jan Zetterström
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  3. Annika López
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  4. Johan Pollack
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  5. Johan Nordenstam
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  6. Anders Mellgren
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Correspondence to Daniel Altman.

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Altman, D., Zetterström, J., López, A. et al. Effect of hysterectomy on bowel function. Dis Colon Rectum 47, 502–509 (2004). https://doi.org/10.1007/s10350-003-0087-5

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  • DOI: https://doi.org/10.1007/s10350-003-0087-5

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