Does simple hysterectomy alter bowel function?

Background And Aims: Hysterectomy is believed to be associated with disturbed defecation, mainly constipation. This study longitudinally describes bowel function in women submitted for hysterectomy.

Material And Methods: Rectoanal manovolumetry, whole gut transit time and detailed interviews on bowel function and dyspareunia were performed preoperatively and at 3 and 11-18 months after hysterectomy in 42 women. Twenty healthy women matched for age and parity served as manovolumetry controls.

Results: No significant changes in anal sphincter pressures could be demonstrated, neither early nor late after hysterectomy. Transit time was unaffected. All but one of the patients claimed that they had been suffering from one or more of the following symptoms; abdominal pain, distension, constipation and dysparenuia. While postoperative interviews revealed a significant improvement with respect to abdominal pain and dyspareunia (P < 0.01) after 3 and 11-18 months, improvement of abdominal distension and constipation proved to be transient only.

Conclusion: Simple abdominal hysterectomy appears not to interfere adversely with bowel function. On the contrary many patients were relieved from abdominal pain present before operation.