title: Effects of colpocleisis on bowel symptoms among women with severe pelvic organ prolapse.
abstract: OBJECTIVE
  Our objective was to evaluate bowel symptoms after colpocleisis.
  
  
  METHODS
  This was a planned ancillary analysis of a prospective, colpocleisis cohort study of 152 women. Those with baseline and 1-year questionnaires (Colorectal-Anal Distress Inventory (CRADI) and the Colorectal-Anal Impact Questionnaire (CRAIQ)) were included. "Bothersome" CRADI symptoms (score>2("moderately", "quite a bit")) were identified. CRADI and CRAIQ scores were compared, and postoperative symptom resolution and new symptom development were measured.
  
  
  RESULTS
  Of 121 (80%) subjects with complete data, mean age was 79.2 +/- 5.4 years and all had stage 3-4 prolapse. Procedures performed: partial colpocleisis (61%), total colpocleisis (39%), levator myorrhaphy (71%), and perineorrhaphy (97%). Bothersome bowel symptom(s) were present in 77% at baseline (obstructive (17-26%), incontinence (12-35%) and pain/irritation (3-34%)). All bothersome obstructive and most bothersome incontinence symptoms were less prevalent 1 year after surgery. CRADI and CRAIQ scores significantly improved. The majority of bothersome symptoms resolved (50-100%) with low rates of de novo symptoms (0-14%).
  
  
  CONCLUSIONS
  Most bothersome bowel symptoms resolve after colpocleisis, especially obstructive and incontinence symptoms, with low rates of de novo symptoms.
authors: Department of Obstetrics and Gynecology, Washington Hospital Center, Washington, DC, USA. Robert.E.Gutman@medstar.net
authors: Robert E
authors: RE
authors: Gutman
authors: Catherine S
authors: CS
authors: Bradley
authors: Wen
authors: W
authors: Ye
authors: Alayne D
authors: AD
authors: Markland
authors: William E
authors: WE
authors: Whitehead
authors: Mary P
authors: MP
authors: Fitzgerald
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005242:Fecal Incontinence / Q000150:complications*; D005260:Female; D006801:Humans; D056887:Pelvic Organ Prolapse / Q000150:complications* / Q000601:surgery*; D020127:Recovery of Function; D014621:Vagina / Q000601:surgery*