[Disabling constipation following Wertheim's radical hysterectomy]

The prognosis of patients after a radical hysterectomy according to Wertheim because of a carcinoma of the cervix is good, yet the long-term morbidity is considerable. In a retrospective investigation regarding constipation, a questionnaire was sent to 48 patients who had undergone hysterectomy in the period 1975-1990 in the Ikazia Hospital, Rotterdam. The response rate was 83%. Of the 40 respondents, 18% acquired constipation after the operation (< 3 times defaecation per week), and 33% needed prolonged straining; 13% had abdominal cramps, 20% had started to use laxatives, 48% had an increased consistency of the faeces, and 40% had to assist defaecation with the fingers. The incidence of chronic constipation after radical hysterectomy according to Wertheim is more than 20%; this kind of morbidity is insufficiently recognised. Operative treatment of these constipated patients can be successful.