Effects of colpocleisis on bowel symptoms among women with severe pelvic organ prolapse.
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.
Gutman
Robert E
RE
Department of Obstetrics and Gynecology, Washington Hospital Center, Washington, DC, USA. Robert.E.Gutman@medstar.net
Bradley
Catherine S
CS
Ye
Wen
W
Markland
Alayne D
AD
Whitehead
William E
WE
Fitzgerald
Mary P
MP
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*