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Saturday, January 25, 2014

Trailers (73): Bowel prep prior to prolapse surgery

Ballard et al. Bowel preparation before vaginal prolapse surgery: a randomized controlled trial.

Why should you read about this topic?

Remember this trailer?  Mechanical bowel prep before laparoscopic gyn surgery. Same reason.

What were the authors trying to do?

Assess the benefits to the surgeon and impact on the patients of mechanical bowel prep prior to vaginal prolapse surgery

Who participated and in what setting?

Women (N=150) at least 20 years old planning apical suspension and posterior colporrhapy at UAB between 2011-2.

What was the study design?

Single-masked randomized controlled trial comparing mechanical bowel prep (clear liquid diet and saline enemas) with no bowel prep.

What were the main outcome measures?

Surgeons’ assessment of bowel contents in the surgical field during the case.  Secondary outcomes included patient satisfaction and bowel symptoms.

What were the results?

Surgeons’ assessment of the operative field was not different between groups.  The bowel prep group was less likely to be satisfied and more likely to have bowel symptoms.

What is the most interesting image in the paper?

Table 2

What were the study strengths and weaknesses?

Strengths: adequately powered randomized controlled trial.  Weaknesses: unvalidated surgeons’ and patients’ assessment scores.

What does the study contribute for your practice?

There is no upside and plenty of downside for bowel prep prior to prolapse surgery.