Anal incontinence and bowel dysfunction after sacrocolpopexy for vaginal vault prolapse.
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.
Forsgren
Catharina
C
Division of Obstetrics and Gynecology, Department of Clinical Sciences, Karolinska Institutet Danderyd Hospital, Stockholm, Sweden.
Zetterström
Jan
J
Zhang
Anju
A
Iliadou
Anastasia
A
Lopez
Annika
A
Altman
Daniel
D
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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