title: Descending perineum syndrome: are abdominal hysterectomy and bowel habits linked?
abstract: OBJECTIVE
  This retrospective study evaluates the effect of abdominal hysterectomy on patients affected by descending perineum syndrome.
  
  
  METHODS
  Eighty-nine female patients affected by descending perineum syndrome and one group of 10 healthy women with normal bowel habits were studied retrospectively. Thirty-two descending perineum syndrome patients (Group 1) had received an abdominal hysterectomy for benign diseases, while 57 descending perineum syndrome patients (Group 2) had not undergone this surgery. All 99 subjects underwent clinical evaluation, computerized anorectal manometry, and defecography.
  
  
  RESULTS
  Dyschezia was found predominantly in Group 2 subjects (P < 0.05). Fecal incontinence was significantly higher in Group 1 than in Group 2 (P < 0.05). The worst anal resting pressure was found in the incontinent Group 1 patients (P < 0.01). Rectoanal intussusception was a significant defecographic sign in Group 1 subjects (P < 0.05).
  
  
  CONCLUSIONS
  Clinical evaluation and instrumental data suggested a possible link between fecal incontinence and abdominal hysterectomy in patients affected by descending perineum syndrome.
authors.affiliation: Dipartimento di Area Critica Medico-Chirurgica, Sezione di Clinica Chirurgica Generale e Discipline Chirurgiche, Unità di Colon-Proctologia, Università di Firenze, Firenze-Careggi, Italy. pucciani@unifi.it
authors.forename: Filippo
authors.initials: F
authors.lastname: Pucciani
authors.forename: Daniele
authors.initials: D
authors.lastname: Boni
authors.forename: Federico
authors.initials: F
authors.lastname: Perna
authors.forename: Gabrio
authors.initials: G
authors.lastname: Bassotti
authors.forename: Massimo
authors.initials: M
authors.lastname: Bellini
mesh_terms: D000368:Aged; D003248:Constipation / Q000503:physiopathology*; D019841:Defecography; D005242:Fecal Incontinence / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007443:Intussusception / Q000503:physiopathology*; D008365:Manometry; D008875:Middle Aged; D017773:Pelvic Floor / Q000503:physiopathology; D010502:Perineum / Q000473:pathology*; D012007:Rectum / Q000503:physiopathology*; D012189:Retrospective Studies; D013577:Syndrome