Zelden defecatieklachten na hysterectomie wegens een benigne aandoening; prospectief onderzoek

To determine the frequency of defecation symptoms after hysterectomy.

Design

Prospective multicentre study, 3 year follow-up.

Methods

404 patients from 13 teaching or non-teaching hospitals in the Netherlands, who underwent hysterectomy for benign disease other than symptomatic uterine prolapse or known endometriosis, were asked to complete the defecation distress inventory before and 3 years after surgery. The defecation distress inventory is a validated disease specific quality of life questionnaire for assessment of the presence and experienced inconvenience of defecation symptoms.

Results

A response rate of 328/372 (88) of 404 patients whose address could be recovered after 3 years was found. De novo constipation occurred in 2 of the patients following hysterectomy. Sensation of anal blockage and incomplete defecation occurred in more than 15 of the patients. Defecation symptoms reported before surgery had persisted in about half of the patients at 3 years after hysterectomy. A feeling of incomplete defecation at 3 years after hysterectomy was more common after subtotal hysterectomy than after total or vaginal hysterectomy (adjusted odds ratio: 2.1 (95 CI: 1.1-3.8) and 1.4 (95 CI: 0.7-2.7), respectively).

Conclusion

Defecation symptoms seldom developed after hysterectomy for benign disease. The type of operation did not play a role.

Ned Tijdschr Geneeskd. 2007;151:1239-43