The effect of hysterectomy on ano-rectal physiology.

Hdl Handle:
http://hdl.handle.net/10147/209180
Title:
The effect of hysterectomy on ano-rectal physiology.
Authors:
Kelly, J L; O'Riordain, D S; Jones, E; Alawi, E; O'Riordain, M G; Kirwan, W O
Affiliation:
Department of General Surgery, Cork University Hospital, Wilton, Ireland.
Citation:
Int J Colorectal Dis. 1998;13(3):116-8.
Journal:
International journal of colorectal disease
Issue Date:
3-Feb-2012
URI:
http://hdl.handle.net/10147/209180
PubMed ID:
9689560
Abstract:
Hysterectomy is associated with severe constipation in a subgroup of patients, and an adverse effect on colonic motility has been described in the literature. The onset of irritable bowel syndrome and urinary bladder dysfunction has also been reported after hysterectomy. In this prospective study, we investigated the effect of simple hysterectomy on ano-rectal physiology and bowel function. Thirty consecutive patients were assessed before and 16 weeks after operation. An abdominal hysterectomy was performed in 16 patients, and a vaginal procedure was performed in 14. The parameters measured included the mean resting, and maximal forced voluntary contraction anal pressures, the recto-anal inhibitory reflex, and rectal sensation to distension. In 8 patients, the terminal motor latency of the pudendal nerve was assessed bilaterally. Pre-operatively, 8 patients were constipated. This improved following hysterectomy in 4, worsened in 2, and was unchanged in 2. Symptomatology did not correlate with changes in manometry. Although, the mean resting pressure was reduced after hysterectomy (57 mmHg-53 mmHg, P = 0.0541), the maximal forced voluntary contraction pressure was significantly decreased (115 mmHg-105 mmHg, P = 0.029). This effect was more pronounced in those with five or more previous vaginal deliveries (P = 0.0244, n = 9). There was no significant change in the number of patients with an intact ano-rectal inhibitory reflex after hysterectomy. There was no change in rectal sensation to distension, and the right and left pudendal nerve terminal motor latencies were unaltered at follow-up. Our results demonstrate that hysterectomy causes a decrease in the maximal forced voluntary contraction and pressure, and this appears to be due to a large decrease in a small group of patients with previous multiple vaginal deliveries.
Language:
eng
MeSH:
Adult; Anal Canal/*physiology; Female; Humans; *Hysterectomy; Hysterectomy, Vaginal; Manometry; Middle Aged; Parity; Prospective Studies; Rectum/*physiology
ISSN:
0179-1958 (Print); 0179-1958 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorKelly, J Len_GB
dc.contributor.authorO'Riordain, D Sen_GB
dc.contributor.authorJones, Een_GB
dc.contributor.authorAlawi, Een_GB
dc.contributor.authorO'Riordain, M Gen_GB
dc.contributor.authorKirwan, W Oen_GB
dc.date.accessioned2012-02-03T15:14:23Z-
dc.date.available2012-02-03T15:14:23Z-
dc.date.issued2012-02-03T15:14:23Z-
dc.identifier.citationInt J Colorectal Dis. 1998;13(3):116-8.en_GB
dc.identifier.issn0179-1958 (Print)en_GB
dc.identifier.issn0179-1958 (Linking)en_GB
dc.identifier.pmid9689560en_GB
dc.identifier.urihttp://hdl.handle.net/10147/209180-
dc.description.abstractHysterectomy is associated with severe constipation in a subgroup of patients, and an adverse effect on colonic motility has been described in the literature. The onset of irritable bowel syndrome and urinary bladder dysfunction has also been reported after hysterectomy. In this prospective study, we investigated the effect of simple hysterectomy on ano-rectal physiology and bowel function. Thirty consecutive patients were assessed before and 16 weeks after operation. An abdominal hysterectomy was performed in 16 patients, and a vaginal procedure was performed in 14. The parameters measured included the mean resting, and maximal forced voluntary contraction anal pressures, the recto-anal inhibitory reflex, and rectal sensation to distension. In 8 patients, the terminal motor latency of the pudendal nerve was assessed bilaterally. Pre-operatively, 8 patients were constipated. This improved following hysterectomy in 4, worsened in 2, and was unchanged in 2. Symptomatology did not correlate with changes in manometry. Although, the mean resting pressure was reduced after hysterectomy (57 mmHg-53 mmHg, P = 0.0541), the maximal forced voluntary contraction pressure was significantly decreased (115 mmHg-105 mmHg, P = 0.029). This effect was more pronounced in those with five or more previous vaginal deliveries (P = 0.0244, n = 9). There was no significant change in the number of patients with an intact ano-rectal inhibitory reflex after hysterectomy. There was no change in rectal sensation to distension, and the right and left pudendal nerve terminal motor latencies were unaltered at follow-up. Our results demonstrate that hysterectomy causes a decrease in the maximal forced voluntary contraction and pressure, and this appears to be due to a large decrease in a small group of patients with previous multiple vaginal deliveries.en_GB
dc.language.isoengen_GB
dc.subject.meshAdulten_GB
dc.subject.meshAnal Canal/*physiologyen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHumansen_GB
dc.subject.mesh*Hysterectomyen_GB
dc.subject.meshHysterectomy, Vaginalen_GB
dc.subject.meshManometryen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshParityen_GB
dc.subject.meshProspective Studiesen_GB
dc.subject.meshRectum/*physiologyen_GB
dc.titleThe effect of hysterectomy on ano-rectal physiology.en_GB
dc.contributor.departmentDepartment of General Surgery, Cork University Hospital, Wilton, Ireland.en_GB
dc.identifier.journalInternational journal of colorectal diseaseen_GB
dc.description.provinceMunster-

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