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Obstructed defecation syndrome in the first week after pelvic reconstructive surgery

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Abstract

Introduction and hypothesis

Research shows that patients are concerned about postoperative bowel function after pelvic reconstructive surgery. The objectives of this study were to estimate the proportion of patients with obstructed defecation syndrome (ODS), a subtype of constipation, in the week after surgery, to identify associated patient-level and perioperative characteristics and the associated bother.

Methods

Women completed a preoperative and postoperative ODS questionnaire and postoperative bowel diary. Characteristics of women with and without postoperative ODS were compared. Chi-squared or Fisher’s exact tests compared categorical variables. Student’s t test or Wilcoxon rank-sum tests compared continuous variables. Multivariate logistic regression was assessed for independent effects. Wilcoxon rank-sum tests compared the groups with regard to bother. Spearman correlation coefficients described the relationship among bother, postoperative ODS score, and bowel diary variables.

Results

Of the 186 participants enrolled, 165 completed the postoperative ODS questionnaire. Of these, 39 women (23.6%, 95% CI 17.2–30.1) had postoperative ODS. Postoperative ODS was significantly associated with preoperative ODS (p < 0.001), posterior colporrhaphy (p = 0.03), surgery type (p = 0.01), and longer duration of surgery (p = 0.03). Using multivariate logistic regression controlling for age, only preoperative ODS was significantly associated with postoperative ODS (OR 2.68, 95% CI 1.73–4.17). Women with postoperative ODS reported more bother with their defecatory symptoms (p < 0.001). The degree of bother was significantly associated with postoperative ODS score (p < 0.001).

Conclusion

Using a validated disease-specific questionnaire to identify ODS, this complication was identified in 23.6% of patients in the week after pelvic reconstructive surgery. Preoperative ODS was a significant and important risk factor for this complication.

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Authors and Affiliations

  1. Department of Gynecology and Obstetrics, Division of Female Pelvic Medicine and Reconstructive Surgery, Johns Hopkins University School of Medicine, Johns Hopkins Bayview Medical Center 4940 Eastern Avenue, 301 Building, Suite 3200, Baltimore, MD, 21224, USA

    Keila S. Muñiz, Prerna R. Pandya, Jacqueline Y. Kikuchi, Danielle Patterson, Chi Chiung Grace Chen & Victoria L. Handa

  2. Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Julia Wainger, Sophia Diaz & Glory E. Mgboji

  3. Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Lisa R. Yanek

  4. Department of Gynecology, Greater Baltimore Medical Center, Baltimore, MD, USA

    Joan Blomquist & Stephanie Jacobs

Authors
  1. Keila S. Muñiz
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  2. Julia Wainger
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  3. Sophia Diaz
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  4. Glory E. Mgboji
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  5. Lisa R. Yanek
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  6. Prerna R. Pandya
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  7. Jacqueline Y. Kikuchi
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  8. Danielle Patterson
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  9. Chi Chiung Grace Chen
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  10. Joan Blomquist
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  11. Stephanie Jacobs
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  12. Victoria L. Handa
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Contributions

K.S. Muñiz: protocol/project development, data collection, manuscript writing/editing; J. Wainger: data collection, manuscript writing/editing; S. Diaz: data collection, manuscript writing/editing; G.E. Mgboji: data collection, manuscript writing/editing; L.R. Yanek: data analysis, manuscript writing/editing; P.R. Pandya: data collection, manuscript review/editing. J.Y. Kikuchi: data collection, manuscript writing/editing; D. Patterson: manuscript writing/editing; C.C.G. Chen: manuscript writing/editing; J. Blomquist: manuscript review/editing; S. Jacobs: manuscript review/editing; V.L. Handa: protocol/project development, manuscript writing/editing.

Corresponding author

Correspondence to Keila S. Muñiz.

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Muñiz, K.S., Wainger, J., Diaz, S. et al. Obstructed defecation syndrome in the first week after pelvic reconstructive surgery. Int Urogynecol J 33, 2985–2992 (2022). https://doi.org/10.1007/s00192-021-04978-6

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  • DOI: https://doi.org/10.1007/s00192-021-04978-6

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