Bowel preparation before vaginal prolapse surgery: a randomized controlled trial.

Area of Science:

• Gynecology
• Surgical Procedures
• Patient Outcomes

Background:

• Reconstructive vaginal prolapse surgery often involves considerations of bowel preparation.
• The impact of mechanical bowel preparation on surgical outcomes and patient experience is not fully elucidated.

Purpose of the Study:

• To compare surgeons' intraoperative assessment of the operative field and patients' satisfaction with or without mechanical bowel preparation before reconstructive vaginal prolapse surgery.

Main Methods:

• A single-blind, randomized trial involving 150 women undergoing vaginal prolapse surgery.
• Patients were allocated to receive mechanical bowel preparation (clear liquid diet, enemas) or a control (regular diet).
• Surgeons' intraoperative assessment of bowel content and patient satisfaction were primary and secondary outcomes, respectively.

Main Results:

• No significant difference was found in surgeons' intraoperative assessment of the surgical field between the bowel preparation and control groups (85% vs. 90% "excellent or good").
• Patients in the bowel preparation group reported significantly lower "complete" satisfaction compared to the control group (OR 0.11, P<.001).
• The bowel preparation group experienced increased abdominal fullness, cramping, fatigue, anal irritation, and hunger pains (all P<.01).

Conclusions:

• Mechanical bowel preparation provides no discernible benefit for surgeons' intraoperative assessment in reconstructive vaginal prolapse surgery.
• Mechanical bowel preparation negatively impacts patient satisfaction and increases the incidence of adverse abdominal symptoms.
• Routine mechanical bowel preparation is not recommended before this type of surgery.