The Effect of Hysterectomy on Colonoscopy Completion

Clancy, Cillian; Burke, John P.; Chang, Kah Hoong; Coffey, J. Calvin

doi:10.1097/dcr.0000000000000223

Cited by 17 publications

(12 citation statements)

References 16 publications

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“…There is some evidence that prior hysterectomy may be associated with greater discomfort during intubation at colonoscopy, and lower cecal intubation rates. 57 Thus it has been suggested that women undergoing colonoscopic surveillance following hysterectomy undergo specific preprocedure counseling and measures to reduce procedural discomfort. 58…”

Section: Introductionmentioning

confidence: 99%

The Manchester International Consensus Group recommendations for the management of gynecological cancers in Lynch syndrome

Crosbie

Ryan

Arends

et al. 2019

Genetics in Medicine

180

216

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PurposeThere are no internationally agreed upon clinical guidelines as to which women with gynecological cancer would benefit from Lynch syndrome screening or how best to manage the risk of gynecological cancer in women with Lynch syndrome. The Manchester International Consensus Group was convened in April 2017 to address this unmet need. The aim of the Group was to develop clear and comprehensive clinical guidance regarding the management of the gynecological sequelae of Lynch syndrome based on existing evidence and expert opinion from medical professionals and patients.MethodsStakeholders from Europe and North America worked together over a two-day workshop to achieve consensus on best practice.ResultsGuidance was developed in four key areas: (1) whether women with gynecological cancer should be screened for Lynch syndrome and (2) how this should be done, (3) whether there was a role for gynecological surveillance in women at risk of Lynch syndrome, and (4) what preventive measures should be recommended for women with Lynch syndrome to reduce their risk of gynecological cancer.ConclusionThis document provides comprehensive clinical guidance that can be referenced by both patients and clinicians so that women with Lynch syndrome can expect and receive appropriate standards of care.

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Section: Introductionmentioning

confidence: 99%

The Manchester International Consensus Group recommendations for the management of gynecological cancers in Lynch syndrome

Crosbie

Ryan

Arends

et al. 2019

Genetics in Medicine

180

216

View full text Add to dashboard Cite

show abstract

“…The reasons for gender differences in pain are not well understood [26 -28]. There may be biological dif-ferences; for instance, greater pain is observed in women who have had a hysterectomy [29,30]. On the other hand, studies have revealed that women expect more pain during flexible sigmoidoscopy compared to men [31], and it is possible that women are more willing to self-report pain compared to men [32].…”

Section: Discussionmentioning

confidence: 99%

Acceptability of two colorectal cancer screening tests: pain as a key determinant in sigmoidoscopy

et al. 2017

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Participants' experience with a screening test can influence adherence, and therefore the efficacy of screening programs. We compared screening with unsedated flexible sigmoidoscopy and fecal immunochemical testing (FIT) for participants' satisfaction with the decision and for willingness to repeat colorectal cancer screening. In a prospective, randomized trial 3257 individuals (50 - 74 years) were invited to either flexible sigmoidoscopy or FIT (1:1), of whom 1650 took up the offer (52.6 %). In total, 1497 screening participants completed at least one questionnaire, either before screening, and/or at three time points in the following year, that measured willingness to repeat screening, willingness to recommend screening, and satisfaction with decision to attend. There were 769 and 728 responders in the flexible sigmoidoscopy and FIT group, respectively. Additionally, 581 flexible sigmoidoscopy participants also completed a pain questionnaire. 1 year later, 10 % of the flexible sigmoidoscopy participants were not willing to repeat screening, compared to 5 % of FIT participants. A higher percentage of women compared to men would not repeat flexible sigmoidoscopy screening (adjusted odds ratio [OR] 2.52, 95 % confidence interval [95 %CI] 1.48 to 4.28). Notably, 22 % of women reported pain during flexible sigmoidoscopy compared to 5 % of men. When we added pain to the statistical model, pain was significantly associated with unwillingness to repeat flexible sigmoidoscopy (OR 3.15, 95 %CI 1.68 to 5.87), while gender was no longer associated (OR 1.53, 95 %CI 0.82 to 2.88). Acceptability for flexible sigmoidoscopy and for FIT was high among Norwegian screening participants, though FIT participants were more willing to repeat screening. Women were less willing to repeat screening with flexible sigmoidoscopy compared to men. This gender difference seemed partly due to pain, and therefore preventable.This study is registered at ClinicalTrials.gov: NCT01538550.

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“…A previous colorectal surgery was strongly associated to polyp retrieval failure. A previous hysterectomy has been related to incomplete colonoscopy, because of a higher frequency of loops and post‐operative fixations 19 . These mechanisms may also occur in patients with a previous colorectal surgery and interfere with the polyp retrieval ratio.…”

Section: Discussionmentioning

confidence: 99%

“…A previous hysterectomy has been related to incomplete colonoscopy, because of a higher frequency of loops and post-operative fixations. 19 These mechanisms may also occur in patients with a previous colorectal surgery and interfere with the polyp retrieval ratio. Of note: Although a previous colorectal surgery has been associated to inadequate bowel preparation, 20,21 these two factors were independent in the multivariate analysis.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for polyp retrieval failure in colonoscopy

et al. 2015

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Introduction: Colonoscopy is able to diagnose, resect and retrieve colonic polyps. Although retrieval of resected polyps is still globally advised, it is not always successful. We aimed to define the risk factors for polyp retrieval failure in colonoscopy. Methods: A single-center, retrospective study assessed 3507 consecutive and non-urgent colonoscopies, performed between September 2011 and December 2012. Colonoscopies were included in our analysis if the diagnosis of at least one polyp was established, and one or more snare polypectomies were performed. Demographic and technical data were collected according to the patient's endoscopy report. Results: A total of 1109 polyps were analyzed, corresponding to 496 colonoscopies from 483 different patients. We found that 53 (4.8%) of the resected polyps were not retrieved. In a univariate analysis, the factors associated with polyp retrieval failure were: age, polyp size, resection technique, bowel preparation, location and the presence of a previous colorectal surgery (p < 0.05). In the multivariate analysis, a previous colorectal surgery, resection by cold snare, location in the right colon, inadequate bowel preparation and a polyp size up to 5 mm were independently associated with higher polyp retrieval failure (p < 0.05). Discussion: Different and well-defined factors were associated with polyp retrieval failure. Because bowel preparation was the only modifiable factor identified, a special focus should be given to this topic.

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The Effect of Hysterectomy on Colonoscopy Completion

Abstract: Colonoscopy completion rates appear decreased in women with a history of hysterectomy, but the available literature is heterogenous. Further studies in this area are warranted.

Cited by 17 publications

References 16 publications

The Manchester International Consensus Group recommendations for the management of gynecological cancers in Lynch syndrome

The Manchester International Consensus Group recommendations for the management of gynecological cancers in Lynch syndrome

Acceptability of two colorectal cancer screening tests: pain as a key determinant in sigmoidoscopy

Risk factors for polyp retrieval failure in colonoscopy

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