Evacuatory Dysfunction Following Gynecologic Surgery
Rather than considering it a loose association of independently functioning organs, the pelvis should be looked upon as an organ system unto itself, composed of subdivisions that rely on each other for normal function. The anterior and posterior compartments share a common nervous system and provide structural support for each other. Therefore, it is easy to see that surgical treatment of one subdivision may have functional impact on the others. In this chapter, we have discussed how radical hysterectomy has been associated with alterations in anorectal function, although an adequate and comprehensive explanation for these findings is currently lacking. Persistent evacuation symptoms may follow surgery for vaginal support defects if there was an incomplete assessment of the pelvic floor before surgery. Similarly, fecal incontinence may persist following repair of a rectovaginal fistula if one did not assess the anal sphincter preoperatively. A multidisciplinary approach to pelvic floor problems is truly required in order to optimize patient care.
KeywordsAnal Sphincter Anal Canal Rectal Prolapse External Anal Sphincter Internal Anal Sphincter
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