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Effect of hysterectomy on bowel function.

Daniel Altman1, Jan Zetterström, Annika López

  • 1Department of Obstetrics and Gynecology, Karolinska Institutet Danderyd Hospital, Stockholm, Sweden. daniel.altman@kvk.ds.sll.se

Diseases of the Colon and Rectum
|March 3, 2004
PubMed
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Abdominal hysterectomy may increase the risk of anal incontinence, especially when combined with salpingo-oopherectomy. Vaginal hysterectomy did not show increased incontinence or constipation risks.

Area of Science:

  • Gynecologic Surgery
  • Gastroenterology
  • Pelvic Floor Disorders

Background:

  • Hysterectomy is a common gynecologic procedure with potential impacts on bowel function.
  • Postoperative bowel dysfunction following hysterectomy is a subject of ongoing research and clinical debate.

Purpose of the Study:

  • To prospectively assess the influence of hysterectomy on bowel function.
  • To differentiate the effects of abdominal versus vaginal hysterectomy on bowel habits.
  • To investigate the role of concomitant salpingo-oopherectomy in postoperative bowel changes.

Main Methods:

  • Prospective study involving 120 patients undergoing hysterectomy for benign conditions.
  • Bowel habits and symptoms assessed via questionnaire preoperatively and at 6 and 12 months postoperatively.

Related Experiment Videos

  • Patients were categorized by surgical approach: vaginal hysterectomy (n=44) and abdominal hysterectomy (n=76), with a subgroup undergoing bilateral salpingo-oopherectomy (n=17).

    • Main Results:

    • Abdominal hysterectomy was associated with increased symptoms of gas incontinence, urge to defecate, and altered stool-gas discrimination (P < 0.05).
    • A trend towards increased fecal incontinence was observed after abdominal hysterectomy, particularly with concomitant bilateral salpingo-oopherectomy.
    • No significant increase in constipation symptoms was noted; defecation frequency increased, and pelvic heaviness symptoms decreased post-abdominal hysterectomy.

    Conclusions:

    • Abdominal hysterectomy may elevate the risk of mild to moderate postoperative anal incontinence.
    • Concomitant bilateral salpingo-oopherectomy further increases the risk of anal incontinence following abdominal hysterectomy.
    • Vaginal hysterectomy was not associated with increased anal incontinence or constipation symptoms; pelvic heaviness symptoms were reduced.