title: Is postoperative bowel function related to posterior compartment prolapse repair?
abstract: OBJECTIVE
  This study aimed to assess how posterior repair (PR) affects change in bowel function in women undergoing anterior/apical surgery for prolapse.
  
  
  METHODS
  We performed a retrospective cohort study of women undergoing prolapse surgery. Our 2 cohorts were women who underwent anterior/apical prolapse surgery either with or without a PR. All women completed the short form of the Colorectal-Anal Distress Inventory (CRADI-8) preoperatively and 6 weeks postoperatively. We compared change in CRADI-8 scores between those who received PR versus those who did not.
  
  
  RESULTS
  Among 238 women who underwent anterior/apical prolapse surgery, 61 (26%) underwent PR, whereas 177 (74%) did not undergo PR. There were no significant differences in mean CRADI-8 scores at baseline or postoperatively, and scores improved significantly in both groups [baseline scores 23.2 (20.2) for PR vs 18.2 (19.3) for no PR, P = 0.12; postoperative scores 5.0 (10.5) for PR vs 8.4 (15.4) for no PR, P = 0.08]. For our primary outcome, we identified a significantly larger margin of symptom improvement in those who underwent PR compared to those who did not [mean CRADI-8 change scores 18.2 (20.1) for PR vs 9.9 (18.6) for no PR, P < 0.01]. In a linear regression model assessing postoperative CRADI-8 scores, women who underwent PR scored 4.9 points lower on the postoperative CRADI-8, suggesting more improvement in bowel-related symptoms, compared to those who did not undergo PR (95% confidence interval, 1.0, 8.8, P = 0.02).
  
  
  CONCLUSIONS
  Women undergoing surgery for anterior/apical prolapse demonstrated significant improvements in bowel symptoms after surgery. Those receiving concomitant PR had a significantly greater margin of improvement.
authors.affiliation: From the *Department of Obstetrics and Gynecology, Duke University, Durham, NC; †Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA; and ‡Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC.
authors.forename: Autumn L
authors.initials: AL
authors.lastname: Edenfield
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Levin
authors.forename: Alexis A
authors.initials: AA
authors.lastname: Dieter
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Wu
authors.forename: Nazema Y
authors.initials: NY
authors.lastname: Siddiqui
mesh_terms: D000368:Aged; D003672:Defecation / Q000502:physiology*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D011184:Postoperative Period; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome