title: Anal incontinence and bowel dysfunction after sacrocolpopexy for vaginal vault prolapse.
abstract: BACKGROUND
  This study aimed to determine the prevalence of bowel dysfunction and anal incontinence in relation to vaginal vault prolapse surgery in women hysterectomized on benign indications.
  
  
  METHODS
  This is a case-control study where women having had sacrocolpopexy (n = 78) were compared with hysterectomized women without sacrocolpopexy (n = 233) using a bowel function questionnaire and the Cleveland Clinic Incontinence Score (CCIS).
  
  
  RESULTS
  Sacrocolpopexy was performed on average 13.7 years (+/-11.1 SD) after the hysterectomy. Sacrocolpopexy was associated with an increased prevalence of rectal emptying difficulties (p = 0.04), incomplete rectal evacuation (p < 0.001), digitally assisted rectal emptying (p < 0.001), and use of enemas (p = 0.001). There was no overall significant difference in mean CCIS when comparing women having had vaginal vault prolapse surgery (CCIS = 2.78 +/- 4.1 SD) with those without (CCIS = 2.1 +/- 3.3 SD, p = 0.1)
  
  
  CONCLUSIONS
  Abdominal sacrocolpopexy is associated with obstructed defecation but not anal incontinence when compared to hysterectomized controls without vaginal vault prolapse surgery.
authors.affiliation: Division of Obstetrics and Gynecology, Department of Clinical Sciences, Karolinska Institutet Danderyd Hospital, Stockholm, Sweden.
authors.forename: Catharina
authors.initials: C
authors.lastname: Forsgren
authors.forename: Jan
authors.initials: J
authors.lastname: Zetterström
authors.forename: Anju
authors.initials: A
authors.lastname: Zhang
authors.forename: Anastasia
authors.initials: A
authors.lastname: Iliadou
authors.forename: Annika
authors.initials: A
authors.lastname: Lopez
authors.forename: Daniel
authors.initials: D
authors.lastname: Altman
mesh_terms: D000368:Aged; D001003:Anal Canal / Q000503:physiopathology*; D003672:Defecation; D005242:Fecal Incontinence / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D012445:Sacrococcygeal Region / Q000601:surgery*; D011795:Surveys and Questionnaires; D014621:Vagina / Q000601:surgery*
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