Obstructed defecation syndrome in the first week after pelvic reconstructive surgery

Muñiz, Keila S.; Wainger, Julia; Diaz, Sophia; Mgboji, Glory E.; Yanek, Lisa R.; Pandya, Prerna R.; Kikuchi, Jacqueline Y.; Patterson, Danielle; Chen, Grace; Blomquist, Joan L.; Jacobs, Stephanie; Handa, Victoria L.

doi:10.1007/s00192-021-04978-6

Cited by 2 publications

(7 citation statements)

References 25 publications

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“…A study of cardiac surgery patients also found that preoperative defecation patterns leaning toward constipation played a role in postoperative constipation 7 . This finding is also supported in the urogynecology literature in a study by Muñiz et al, 6 which found that surgical patients with preoperative obstructive defecation syndrome were more likely to experience postoperative obstructive defecation–type constipation. Preoperative interventions in these patients may be of benefit and could be an area for future research.…”

Section: Discussionmentioning

confidence: 65%

“…Several studies have examined the use of these postoperative regimens and have found a shortened time to first bowel movement (BM) with a combination of these medications when compared with placebo 2–5 . Despite the use of these regimens, most patients do not have their first BM until the second or third postoperative day, and this can result in significant distress, discomfort, and fecal impaction 6 …”

mentioning

confidence: 99%

“…Postoperative constipation is a multifactorial process, and an alternative approach involves consideration of the preoperative period. Preoperative defecation patterns can be a factor in the development of postoperative constipation 6,7 . We are not aware of any studies looking at the effect of preoperative intervention on postoperative bowel function, particularly the use of preoperative fiber supplementation.…”

mentioning

confidence: 99%

“…[2][3][4][5] Despite the use of these regimens, most patients do not have their first BM until the second or third postoperative day, and this can result in significant distress, discomfort, and fecal impaction. 6 Postoperative constipation is a multifactorial process, and an alternative approach involves consideration of the preoperative period. Preoperative defecation patterns can be a factor in the development of postoperative constipation.…”

mentioning

confidence: 99%

“…Preoperative defecation patterns can be a factor in the development of postoperative constipation. 6,7 We are not aware of any studies looking at the effect of preoperative intervention on postoperative bowel function, particularly the use of preoperative fiber supplementation.…”

mentioning

confidence: 99%

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The Effect of Preoperative Fiber on Postoperative Bowel Function After Pelvic Reconstructive Surgery: A Randomized Controlled Trial

Maheshwari

Hall

Jia

et al. 2022

UROGC

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Importance There are limited studies evaluating the effect of preoperative interventions on postoperative bowel function after prolapse surgery. Objective The objective of this study was to evaluate if preoperative fiber intake reduces time to first bowel movement after surgery for pelvic organ prolapse. Study Design We performed a randomized controlled trial of women undergoing pelvic organ prolapse surgery between July 2019 and May 2021. Participants were recruited at their preoperative visit and randomized to receive either 3.4 g psyllium fiber supplementation twice a day for 1 week before surgery or no fiber supplementation before surgery. Postoperative bowel regimen was standardized for both groups. Participants completed a bowel diary for their first postoperative bowel movement after surgery characterized by the Bristol Stool Scale and any associated pain or urgency. The primary outcome was time to first bowel movement. Secondary outcomes included pain associated with first bowel movement. Results Eighty-four patients were enrolled in the study. Seventy-one patients had complete data for primary analysis, with 35 patients in the intervention group and 36 patients in the control group. Demographic and perioperative characteristics were similar between the groups. There was no difference found between the groups with respect to time to first bowel movement (control: 68.3 [SD, 25] hours vs intervention: 66.5 [SD, 23] hours, P = 0.749). There was no difference found with pain associated with first bowel movement (visual analog scale median [interquartile range] control: 2.0 [0.0–4.0] vs intervention: 2.0 [1.0–4.0]; P = 0.655). Conclusions Preoperative fiber supplementation before prolapse surgery does not improve time to first bowel movement after surgery.

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Section: Discussionmentioning

confidence: 65%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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The Effect of Preoperative Fiber on Postoperative Bowel Function After Pelvic Reconstructive Surgery: A Randomized Controlled Trial

Maheshwari

Hall

Jia

et al. 2022

UROGC

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Pudendal Nerve Block With Liposomal Bupivacaine for Sacrospinous Ligament Suspension

Ezzedine

Dhariwal

Wasenda

et al. 2023

UROGC

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Importance Pudendal nerve block has been frequently used as a pain management modality for vaginal prolapse surgery. However, studies investigating its efficacy and the type of anesthetic used have had conflicting results. Objective This study aimed to evaluate the effect of intraoperative pudendal nerve block with liposomal bupivacaine on postoperative pain after sacrospinous ligament suspension surgery. Study Design In this single-blinded randomized controlled trial, 83 women undergoing sacrospinous ligament suspension were randomized to receive either intraoperative pudendal nerve block with liposomal bupivacaine or no block. Participants recorded their pain level on postoperative days (PODs) 1–3 and 7, the number of pain medication pills consumed, and the quality of their recovery using a validated questionnaire. Results There were no significant differences in pain scores between the groups on POD 1 and POD 3: 5 (2–6.25) versus 5.5 (4–8; P = 0.058) and 4 (1–6) versus 5 (2–7; P = 0.146), respectively. On POD 2, the overall pain score was statistically different between the groups, with the block group having lower interquartile ranges. This difference, however, was not clinically significant: 5 (1.75–5) versus 5 (3.25–7.75; P = 0.023). In the subset of participants who underwent a concomitant midurethral sling procedure, POD 2 and POD3 pain scores were significantly lower in those who received the block: 3 (1–5) versus 6 (5–8; P = 0.006) for POD 2 and 3 (1–5) versus 5 (3.250–7; P = 0.042) for POD 3. There were no significant differences in pain medication consumption or the quality of recovery scores. Conclusion Pudendal nerve block with liposomal bupivacaine did not result in significant differences in postoperative pain after sacrospinous ligament suspension, except in those participants who underwent a concomitant midurethral sling procedure.

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Obstructed defecation syndrome in the first week after pelvic reconstructive surgery

Cited by 2 publications

References 25 publications

The Effect of Preoperative Fiber on Postoperative Bowel Function After Pelvic Reconstructive Surgery: A Randomized Controlled Trial

The Effect of Preoperative Fiber on Postoperative Bowel Function After Pelvic Reconstructive Surgery: A Randomized Controlled Trial

Pudendal Nerve Block With Liposomal Bupivacaine for Sacrospinous Ligament Suspension

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