Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Feb 1;29(2):175-182.
doi: 10.1097/SPV.0000000000001281.

Prevention of Postoperative Constipation in Urogynecology Patients: A Systematic Review

Carson F Woodbury  1 , Arielle C Coughlin, Bethany Dubois, Anna Romanova
Affiliations

Prevention of Postoperative Constipation in Urogynecology Patients: A Systematic Review

Carson F Woodbury et al. Urogynecology (Phila). .

Abstract

Importance: Constipation is common after pelvic surgery, and studies suggest that surgeons underestimate the negative impact of constipation on patients. Patients undergoing pelvic reconstructive surgery are a unique population requiring special consideration in the prevention and management of constipation.

Objective: This study aimed to systematically review the literature to identify evidence for prevention of postoperative constipation with medications or fiber in patients undergoing reconstructive pelvic surgery.

Study design: A structured literature search was performed of five databases (MEDLINE, Embase, Scopus, Web of Science, the Cochrane Library) from inception to June 2022 for studies of postoperative laxative or fiber use in adult patients undergoing benign pelvic reconstructive surgery. Studies of preoperative bowel preparation and nonsurgical patients were excluded. Data on postoperative constipation were extracted for a qualitative analysis of the literature. Grading of Recommendations Assessment, Development, and Evaluation methodology was applied to assess the quality of evidence.

Results: We identified 86 references after deduplication. Only 4 studies with a total of 344 patients were eligible for inclusion in the review. The included studies were all randomized controlled trials assessing time to first bowel movement with the earliest published in 2010. Laxative use decreased constipation more than placebo. Multiple-agent laxative use appeared to decrease bothersome constipation more than single-agent docusate. Preoperative fiber did not decrease constipation. By Grading of Recommendations Assessment, Development, and Evaluation criteria, all four studies provide moderate-quality evidence.

Conclusions: Few studies have investigated laxative regimens in patients after urogynecologic surgery. The available literature is moderate quality and suggests benefit of multiple-agent treatment over docusate only or no treatment.

PubMed Disclaimer

Conflict of interest statement

The authors have declared they have no conflicts of interest.

References

    1. Eberhart L, Aust H, Schuster M, et al. Preoperative anxiety in adults — a cross-sectional study on specific fears and risk factors. BMC Psychiatry 2020;20(1):140. doi: 10.1186/s12888-020-02552-w. - DOI
    1. Dennison C, Prasad M, Lloyd A, et al. The health-related quality of life and economic burden of constipation. Pharmacoeconomics 2005;23(5):461–476. doi: 10.2165/00019053-200523050-00006. - DOI
    1. Caljouw MAA, Hogendorf-Burgers MEHJ. GYNOTEL: telephone advice to gynaecological surgical patients after discharge. J Clin Nurs 2010;19:3301–3306. doi: 10.1111/j.1365-2702.2010.03395.x. - DOI
    1. Ramaseshan AS, LaSala C, O’Sullivan DM, et al. Patient-initiated telephone calls in the postoperative period after female pelvic reconstructive surgery. Female Pelvic Med Reconstr Surg 2020;26(10):626–629. doi: 10.1097/SPV.0000000000000636. - DOI
    1. Dunivan GC, Sussman AL, Jelovsek JE, et al. Gaining the patient perspective on pelvic floor disorders' surgical adverse events. Am J Obstet Gynecol 2019;220:185e1–185e10. doi: 10.1016/j.ajog.2018.10.033. - DOI

Publication types

LinkOut - more resources