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    The effect of hysterectomy on ano-rectal physiology.

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    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.
    Issue Date
    2012-02-03T15:14:23Z
    MeSH
    Adult
    Anal Canal/*physiology
    Female
    Humans
    *Hysterectomy
    Hysterectomy, Vaginal
    Manometry
    Middle Aged
    Parity
    Prospective Studies
    Rectum/*physiology
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    Citation
    Int J Colorectal Dis. 1998;13(3):116-8.
    Journal
    International journal of colorectal disease
    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
    ISSN
    0179-1958 (Print)
    0179-1958 (Linking)
    Collections
    Cork University Hospital

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