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Female Pelvic Medicine & Reconstructive Surgery:
doi: 10.1097/SPV.0000000000000048
Original Articles

Is Postoperative Bowel Function Related to Posterior Compartment Prolapse Repair?

Edenfield, Autumn L. MD*; Levin, Pamela J. MD; Dieter, Alexis A. MD*; Wu, Jennifer M. MD, MPH; Siddiqui, Nazema Y. MD, MHSc*

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Abstract

Objectives

This study aimed to assess how posterior repair (PR) affects change in bowel function in women undergoing anterior/apical surgery for prolapse.

Methods

We performed a retrospective cohort study of women undergoing prolapse surgery. Our 2 cohorts were women who underwent anterior/apical prolapse surgery either with or without a PR. All women completed the short form of the Colorectal-Anal Distress Inventory (CRADI-8) preoperatively and 6 weeks postoperatively. We compared change in CRADI-8 scores between those who received PR versus those who did not.

Results

Among 238 women who underwent anterior/apical prolapse surgery, 61 (26%) underwent PR, whereas 177 (74%) did not undergo PR. There were no significant differences in mean CRADI-8 scores at baseline or postoperatively, and scores improved significantly in both groups [baseline scores 23.2 (20.2) for PR vs 18.2 (19.3) for no PR, P = 0.12; postoperative scores 5.0 (10.5) for PR vs 8.4 (15.4) for no PR, P = 0.08]. For our primary outcome, we identified a significantly larger margin of symptom improvement in those who underwent PR compared to those who did not [mean CRADI-8 change scores 18.2 (20.1) for PR vs 9.9 (18.6) for no PR, P < 0.01]. In a linear regression model assessing postoperative CRADI-8 scores, women who underwent PR scored 4.9 points lower on the postoperative CRADI-8, suggesting more improvement in bowel-related symptoms, compared to those who did not undergo PR (95% confidence interval, 1.0, 8.8, P = 0.02).

Conclusions

Women undergoing surgery for anterior/apical prolapse demonstrated significant improvements in bowel symptoms after surgery. Those receiving concomitant PR had a significantly greater margin of improvement.

Copyright © 2014 by Lippincott Williams & Wilkins

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