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Clinical and Experimental Obstetrics & Gynecology  2020, Vol. 47 Issue (5): 744-748    DOI: 10.31083/j.ceog.2020.05.5318
Original Research Previous articles | Next articles
Development of abnormal bowel function after simple hysterectomy
P. Phangsuwan1, P. Suprasert1, *()
1Department of Obstetrics and Gynecology. Faculty of Medicine, Chiang Mai University Chiang Mai 50200, Thailand
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Abstract  

Objective: To evaluate patient bowel function following trans-abdominal hysterectomy (TAH). Materials and Methods: Patients scheduled for TAH were interviewed using a bowel function questionnaire at day 1 preoperatively and at 1, 3 and 6 months postoperatively. The questionnaire consisted of 18 items pertaining to bowel function, each with 5 score levels (0 to 4). A low score indicated fewer symptoms, with the sum of possible scores ranging from 0-72. Results: Seventy-four patients were recruited between March and September 2017. The mean patient age was 51.3 years and the most common diagnosis was myoma (41.9%) followed by endometrial cancer (18.9%), ovarian cancer (12.2%) and ovarian tumor (12.2%). Previous cesarean section was reported in 24.3% of patients, while 30% underwent lysis of adhesions. Gastrointestinal medication and laxatives were given to 70% and 2.7% of patients, respectively. The mean sum of the score for the questionnaire was 1.91, 0.81, 0.54 and 0.46, respectively, for preoperative day one and for 1, 3 and 6 months postoperatively. The mean scores for the 3 post-operative time points were significantly lower than that of the preoperative period. Conclusion: Most patients who underwent TAH did not develop abnormal bowel function after surgery. Moreover, patients who initially had bowel dysfunction showed significant improvement post-hysterectomy.

Key words:  Bowel function      Simple hysterectomy     
Submitted:  24 July 2019      Accepted:  30 October 2019      Published:  15 October 2020     
Fund: National Research University Project under Thailand's Office of Higher Education Commission and Chiang Mai University
*Corresponding Author(s):  P. Suprasert     E-mail:  psuprase@gmail.com

Cite this article: 

P. Phangsuwan, P. Suprasert. Development of abnormal bowel function after simple hysterectomy. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(5): 744-748.

URL: 

https://ceog.imrpress.com/EN/10.31083/j.ceog.2020.05.5318     OR     https://ceog.imrpress.com/EN/Y2020/V47/I5/744

Figure 1.  — Consort of Participants.

Table 1  — Patient Characteristics (N = 74).
N
Mean Age (year) (SD) 51.34 (8.98)
Mean BMI (kg/m2) (SD) 24.11 (3.77)
Mean Hospital Stay (Day) (SD) 7.18 (2.38)
Mean Estimated Blood Loss (mL) (SD) 241.62 (209.31)
Mean Operative Time (min) (SD) 146.54 (41.84)
Mean Duration of Antibiotic (Days) (SD) 6.18 (3.57)
Mean Duration of Morphine (Days) (SD) 1.47 (0.579)
Marital Status
Single
Married
Divorce
Widow

9 (12.2%)
62 (83.3%)
2 (2.7%)
1(1.4%)
Parity
Nulliparity
Multiparity

20 (27.0%)
54 (73.0%)
History of Abortion 13 (17.6%)
Previous Cesarean Section
1 Time
2 Times

10 (13.5%)
8 (10.8%)
Previous Other Surgery 5 (6.8%)
Diagnosis
Myoma
CA Corpus
CA Ovary
Ovarian Tumor
Adenomyosis
Other *

31 (41.9%)
14 (18.9%)
9 (12.2%)
9 (12.2%)
6 (8.1%)
5 (6.8%)
Uterine Size (Weeks)
Normal
8-10
12-14
16-18
> 18-24

23 (31.1%)
16 (21.6%)
19 (25.7%)
10 (13.5%)
6 (8.1%)
Adding Procedure (Beyond Hysterectomy)
Unilateral Salpingo-Oophorectomy
Bilateral Salpingoo-Ophorectomy
Adhesiolysis
Developed Rectovaginal Space
Omentectomy
Lymphadenectomy
Other #

6(8.1%)
51 (68.9%)
22 (29.7%)
13 (17.6%)
16 (21.6%)
16 (21.6%)
4 (5.4%)
Adhesion in Cul-De Sac 12 (16.2%)
Postoperative Laxative Usage 2 (2.7%)
Postoperative Gastrointestinal Drug Usage
Omeprazole
Simeticone (Air-X?)
Antiemetic
Hyoscine Butylbromide (Buscopan?)

15 (20.3%)
29 (39.2%)
6 (8.1%)
2 (2.7%)
Perioperative Complication
None
Fever
Wound Infection
Bowel Ileus
Urinary Tract Infection

61 (82.4%)
9 (12.2%)
2 (2.7%)
1 (1.4%)
1 (1.4%)
Table 2  — Summary of Gastrointestinal Quality of Life Index Questionnaire Scores (N = 74).
Time Mean SD Median Range 95% CI p Value*
Preoperative 1.91 4.224 0 0-25 0.93-2.88 -
1 Months 0.81 1.440 0 0-6 0.198-1.991 0.017
3 Months 0.54 1.377 0 0-8 0.384-2.346 0.007
6 Months 0.46 1.218 0 0-8 0.452-2.440 0.005
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