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Relationship of gynecologic surgery to constipation
1Brookwood Women's Medical Center, C. Paul Perry PelvicPain Center, Birmingham, AL 35209, USA.
Study Objective:
To determine if women undergoing presacral neurectomy, hysterectomy, or other gynecologic surgery experience a greater frequency of constipation than those having no surgery.
Design:
Concurrent, nonrandomized, retrospective study (Canadian Task Force classification II-2).
Setting:
Tertiary medical care center with referral-based practice for the treatment of chronic pelvic pain.
Patients:
Two hundred fifty-six women forming four groups based on surgical procedure: presacral neurectomy (66), hysterectomy (65), other gynecologic surgery (68), and no surgery (57).
Interventions:
Laparoscopic presacral neurectomies. Other gynecologic surgery included laparoscopy, dilatation and curettage, laparoscopic resection of endometriosis, or any combination of these procedures.
Measurements And Main Results:
Constipation was defined as decrease in frequency of spontaneous bowel movements. A statistically significant greater percentage of patients undergoing surgical procedures were more constipated than those having no surgery: presacral neurectomy, 31.8%; hysterectomy, 27.7%; other gynecologic surgery, 25%; and no gynecologic surgery, 10.5%.
Conclusion:
Pelvic surgery may cause parasympathetic nerve dysfunction leading to constipation. (J Am Assoc Gynecol Laparosc 6(1):75-78, 1999)