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Why is colonoscopy more difficult in women?
B P Saunders1, M Fukumoto, S Halligan
1Department of Endoscopy, St. Mark's Hospital, London, England.
Gastrointestinal Endoscopy
|February 1, 1996
Summary
Colonoscopy is technically more difficult in women due to their longer colons. This study found women have longer colons, particularly the transverse colon, contributing to procedural challenges.
Area of Science:
- Gastroenterology
- Anatomy
- Medical Imaging
Background:
- Colonoscopy is frequently more challenging in female patients.
- A retrospective review indicated 31% of colonoscopies in women were difficult compared to 16% in men.
Purpose of the Study:
- To investigate the anatomical basis for increased technical difficulty during colonoscopy in women.
- To compare colonic length and mobility between male and female patients.
Main Methods:
- Analysis of normal barium enema series from 183 women and 162 men.
- Independent measurements of colonic length and mobility by two blinded physicians.
Main Results:
- Women possess significantly longer total colons (155 cm) than men (145 cm), despite smaller stature.
- Women have a longer transverse colon (48 cm vs. 40 cm) and it more frequently reaches the true pelvis (62% vs. 26%).
- No significant differences were observed in other colonic segment lengths or colonic mobility.
Conclusions:
- Colonoscopy is indeed a more technically difficult procedure in women.
- Anatomical differences, specifically a longer colon, likely contribute to the increased difficulty.