Anorectal dysfunction after surgical treatment for cervical cancer

Anil K. Sood, Ingrid Nygaard, Mark S. Shahin, Joel I. Sorosky, Susan K. Lutgendorf, Satish Sanku Chander Rao

Research output: Contribution to journalArticle

68 Citations (Scopus)

Abstract

BACKGROUND: Although bowel symptoms and complaints are common after radical hysterectomy, the effects of operation on anorectal function are incompletely understood. In this prospective pilot study we evaluated the incidence of bowel symptoms, changes in anorectal physiology, and quality of life after radical hysterectomy. STUDY DESIGN: Eleven women undergoing radical hysterectomy for early-stage cervical cancer completed bowel function symptom surveys and cancer-specific quality-of-life scales before operation and at 6 weeks and 6 months after operation. The bowel function symptom survey was also repeated at 18 months postoperation. Anorectal manometry, balloon defecation, and pudendal nerve latency tests were performed before the operation and 6 months postoperatively. RESULTS: The mean age was 45.3 years (range 34 to 56 years), and four of the patients were postmenopausal. Resting and squeeze sphincter pressures, volume of saline infused at first leak, total volume retained, and threshold volume for maximum tolerable volume were all decreased significantly (p < 0.05) after operation. Pudendal nerve terminal motor latency increased (p < 0.05) bilaterally. There were no significant differences in sensory thresholds. At 18 months, two women reported constipation, six reported flatus incontinence, and two reported fecal incontinence. The total quality-of-life score declined at 6 weeks but then improved significantly by 6 months (p = 0.02). CONCLUSIONS: Bowel dysfunction is common after radical hysterectomy. Many women exhibit manometric and subjective changes compatible with fecal incontinence.

Original languageEnglish (US)
Pages (from-to)513-519
Number of pages7
JournalJournal of the American College of Surgeons
Volume195
Issue number4
DOIs
StatePublished - Oct 1 2002
Externally publishedYes

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Hysterectomy
Uterine Cervical Neoplasms
Pudendal Nerve
Fecal Incontinence
Quality of Life
Sensory Thresholds
Flatulence
Defecation
Manometry
Constipation
Therapeutics
Prospective Studies
Pressure
Incidence
Neoplasms
Surveys and Questionnaires

ASJC Scopus subject areas

  • Surgery

Cite this

Anorectal dysfunction after surgical treatment for cervical cancer. / Sood, Anil K.; Nygaard, Ingrid; Shahin, Mark S.; Sorosky, Joel I.; Lutgendorf, Susan K.; Rao, Satish Sanku Chander.

In: Journal of the American College of Surgeons, Vol. 195, No. 4, 01.10.2002, p. 513-519.

Research output: Contribution to journalArticle

Sood, Anil K. ; Nygaard, Ingrid ; Shahin, Mark S. ; Sorosky, Joel I. ; Lutgendorf, Susan K. ; Rao, Satish Sanku Chander. / Anorectal dysfunction after surgical treatment for cervical cancer. In: Journal of the American College of Surgeons. 2002 ; Vol. 195, No. 4. pp. 513-519.
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