Patient Expectations and Experiences With Postoperative Bowel Function

Postoperative constipation can affect quality of life and satisfaction in patients undergoing urogynecologic surgery.

The objectives of this study were to compare preoperative expectations regarding postoperative bowel function to patients' actual experiences after surgery, and to examine patient-reported use and satisfaction with polyethylene glycol.

This was a prospective cohort study of women undergoing urogynecologic surgery. Before surgery, participants were asked to complete a survey on baseline bowel function and postoperative bowel function expectations, which included the validated Wexner constipation questionnaire. Participants were again surveyed at 1 week and 6 weeks postoperatively regarding their experiences with postoperative bowel movements and use of polyethylene glycol. Patient Global Impressions of Improvement were used to measure postoperative improvement in bowel function.

Of 86 enrolled participants, 83 (96.5%) completed the 1-week and 77 (89.5%) completed the 6-week follow-up. Some participants reported improvement in bowel movements at 1 week (53%), and more at 6 weeks (65%). Presence of preoperative concerns about first bowel movement did not influence perception of improvement at 1 week (55% vs 45%, respectively, P=0.33) or at 6 weeks (62.2% vs 52.5%, P=0.37). At 6 weeks, those who continued to use polyethylene glycol were more likely to report postoperative bowel improvement (84.4% vs 50%, P=0.002).

Most patients experience improvement in bowel function after urogynecologic surgery. Preoperative concerns do not seem to affect self-reported improvement. Some patients taking polyethylene glycol experience improvement in bowel function as early as 1 week after urogynecologic surgery, with more improvement at 6 weeks.