Introduction and Hypothesis
To characterize postoperative bowel symptoms in women undergoing vaginal prolapse reconstructive surgery randomized to preoperative bowel preparation versus regular diet.
Subjects (N = 121) completed two bowel diaries: a 7-day bowel diary immediately prior to surgery and a 14-day diary postoperatively. Self-reported bowel diary data and symptoms included the time to first bowel movement (BM), daily number of BMs, Bristol Stool Form Scale score, pain and urgency associated with BM, episodes of fecal incontinence, and use of laxatives. Antiemetic use was abstracted from medical records. Outcomes were compared between groups using chi-squared/Fisher's exact test or Student's t-test as appropriate.
Mean time to first postoperative BM was similar between the bowel prep (n=60) and control groups (n=61), 81.2 ± 28.9 vs 78.6± 28.2 hrs, p=0.85. With the first BM, there were no differences between bowel preparation and control groups regarding pain (17.2% vs 27.9%, p=0.17), fecal urgency with defecation (56.9% vs 52.5%, p=0.63), fecal incontinence (14% vs 15%, p=0.88) and >1 use of laxatives (93.3% vs 96.7% p=0.44), respectively. Antiemetic use was similar in both groups (48.3% vs 55.7%, respectively, p=0.42).
There were no differences in return of bowel function and other bowel symptoms postoperatively between randomized groups. Lack of bowel preparation does not impact the risk of painful defecation postoperatively. This information may be used to inform patients regarding expectations for bowel function after vaginal reconstructive surgery.