Biofeedback therapy for female patients with constipation caused by radical hysterectomy or vaginal delivery

Chronic constipation is frequently seen in women who have undergone hysterectomy or delivery. However, reports regarding anorectal physiologic features in those patients are rare. Patients with constipation associated with either radical hysterectomy or vaginal delivery were analyzed in order to cla...

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Bibliographic Details
Published in:Journal of gastroenterology and hepatology 2013-07, Vol.28 (7), p.1133-1140
Main Authors: Park, Soo-Kyung, Myung, Seung-Jae, Jung, Kee Wook, Chun, Yoon Hee, Yang, Dong-Hoon, Seo, So-Young, Ku, Hyun-Sook, Yoon, In Ja, Kim, Kyung Jo, Ye, Byong Duk, Byeon, Jeong-Sik, Jung, Hwoon-Yong, Yang, Suk-Kyun, Kim, Jin-Ho
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Anal Canal - physiopathology
Biofeedback, Psychology - methods
Constipation - etiology
Constipation - physiopathology
Constipation - therapy
Defecation - physiology
Delivery, Obstetric - adverse effects
Female
Humans
Hysterectomy - adverse effects
Middle Aged
Rectum - physiopathology
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Summary:Chronic constipation is frequently seen in women who have undergone hysterectomy or delivery. However, reports regarding anorectal physiologic features in those patients are rare. Patients with constipation associated with either radical hysterectomy or vaginal delivery were analyzed in order to clarify the anorectal physiologic features and the effectiveness of biofeedback therapy. Of the constipated patients, a hysterectomy group (n = 40), delivery group (n = 41), and a control group (n = 89), who had no history of either surgery or delivery before developing functional constipation were included. Their anorectal physiological tests and the effectiveness of biofeedback therapy were investigated. The volume of desire to defecate was greater in the hysterectomy group than in the control group (86.5 ± 55.0 mL vs 62.9 ± 33.7 mL; P = 0.03), and more than 240 mL of maximal volume of toleration was more frequently noted in the hysterectomy group (32.5%) than in the delivery group (14.6%) and control group (13.5%) (P = 0.02).The failure of balloon expulsion was more frequently noted in the delivery group (44.0%) than in the hysterectomy group (15.0%) and control group (25.0%) (P = 0.01). The defecation satisfaction score was significantly increased after biofeedback therapy in the hysterectomy group (2.0 ± 2.7 vs 7.8 ± 1.5, P 
ISSN:1440-1746
DOI:10.1111/jgh.12158