Related Experiment Videos
Disordered colorectal motility in intractable constipation following hysterectomy
A N Smith1, J S Varma, N R Binnie
1University Department of Surgery, Western General Hospital, Edinburgh, UK.
The British Journal of Surgery
|December 1, 1990
Summary
Hysterectomy may cause severe constipation in women due to impaired autonomic innervation of the hindgut. Studies show altered rectal function and colon motility, leading to functional obstruction after the procedure.
Area of Science:
- Gastroenterology
- Urology
- Gynecology
Background:
- Hysterectomy is a common gynecological procedure.
- Post-hysterectomy syndrome can include constipation and urinary symptoms.
- The impact of hysterectomy on colorectal and anal sphincter function is not fully understood.
Purpose of the Study:
- To investigate colorectal and anal sphincter motility and electrophysiology in women with post-hysterectomy constipation.
- To compare these functions with asymptomatic controls.
- To identify potential mechanisms for constipation after hysterectomy.
Main Methods:
- Motility and electrophysiology studies of the colorectal and anal sphincters.
- Proctometrograms to assess rectal compliance and sensory function.
- Pharmacological provocation (Prostigmin, carbachol) to evaluate autonomic innervation.
Main Results:
- No differences in anal sphincter motor function or pudendoanal reflex latency.
- Increased rectal volumes and compliance with sensory deficits in hysterectomy patients.
- Reversed sigmoid colon motility gradient after Prostigmin in hysterectomy patients, indicating functional obstruction.
- Denervation supersensitivity observed in some hysterectomy patients.
Conclusions:
- Hysterectomy can lead to autonomic denervation of the hindgut.
- This dysfunction contributes to severe constipation and functional obstruction.
- Altered rectal and colonic motility are key findings in post-hysterectomy constipation.