Anal incontinence and bowel dysfunction after sacrocolpopexy for vaginal vault prolapse

Abstract

Introduction: This study aimed to determine the prevalence of bowel dysfunction and anal incontinence in relation to vaginal vault prolapse surgery in women hysterectomized on benign indications.

Methods: This is a case-control study where women having had sacrocolpopexy (n = 78) were compared with hysterectomized women without sacrocolpopexy (n = 233) using a bowel function questionnaire and the Cleveland Clinic Incontinence Score (CCIS).

Results: Sacrocolpopexy was performed on average 13.7 years (+/-11.1 SD) after the hysterectomy. Sacrocolpopexy was associated with an increased prevalence of rectal emptying difficulties (p = 0.04), incomplete rectal evacuation (p < 0.001), digitally assisted rectal emptying (p < 0.001), and use of enemas (p = 0.001). There was no overall significant difference in mean CCIS when comparing women having had vaginal vault prolapse surgery (CCIS = 2.78 +/- 4.1 SD) with those without (CCIS = 2.1 +/- 3.3 SD, p = 0.1)

Conclusions: Abdominal sacrocolpopexy is associated with obstructed defecation but not anal incontinence when compared to hysterectomized controls without vaginal vault prolapse surgery.