Postoperative Bowel Symptoms Improve over Time after Rectosigmoidectomy for Endometriosis

Marco Antonio Bassi, Marco Bassi, Bassi MA, Marina Paula Andres, Bassi CM, Carolina Morales Bassi, João Siufi Neto, Neto JS, Rosanne M. Kho, Kho RM, Maurício Simões Abrão, Mauricio Simões Abrão, Abrão MS
Journal of Minimally Invasive Gynecology · 2019 · vol. 27(6) , pp. 1316–1323 · doi:10.1016/j.jmig.2019.10.009 · PMID:31669552 · W2982155855
article OA: closed CC0 ⤵ 12 in-corpus citations
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This study investigated the temporal changes in bowel symptoms following rectosigmoidectomy for endometriosis, finding that these symptoms generally improved over the postoperative period.

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Abstract

Study objectiveTo evaluate bowel function (changes in stool caliber, sensation of incomplete evacuation, stooling frequency, and rectal bleeding) and urinary function (dysuria and retention) after segmental resection in patients with bowel endometriosis.DesignRetrospective study.SettingTertiary hospital.PatientsA total of 413 (mean age = 33.6 ± 5.1 years) of reproductive aged women, with bowel endometriosis that underwent segmental bowel resection of the rectosigmoid from 2005 to 2018, without history of prior bowel surgery, without existing or history of malignancy.InterventionsLaparoscopic segmental bowel resection performed by the same team and with the same technique.Measurements and main resultsData collected from the patients' records included length of resected segment, distance of the lesion from the anal verge, and complications. Information on intestinal and urinary function was obtained from a questionnaire applied before the surgery and at 2, 6, and 12 months after the surgery. There was a significant increase in the incidence of stool thinning and rectal bleeding 2 months after surgical procedure; these symptoms decreased significantly over time. The incidence of urinary symptoms decreased significantly over time after surgery. The length of the bowel segment resected was not associated with the postoperative symptoms, but the rectosigmoid lesion was significantly closer to the anal verge in patients with rectal bleeding and urinary symptoms. There was no association between the length of intestinal segment resected and the frequency of stooling. At 6 months, patients who had a decreased frequency of stooling underwent a resection closer to the anal verge (9.7 cm) in comparison with the ones with unchanged or increase frequency of stooling (10.1 cm and 10.7 cm, respectively; p <.05).ConclusionPatient complaints on bowel and urinary alterations after segmental resection were transient with significant improvement over time up to 12 months. Bowel and urinary symptoms were not associated with the size of the bowel segment resected, whereas rectal bleeding at 2 months after surgery was significantly associated with the distance from anal verge. Segmental resection was also associated with a great improvement in constipation at 12 months postoperative.

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Condition tags

endometriosis

MeSH descriptors

Digestive System Surgical Procedures Endometriosis Postoperative Complications Rectal Diseases Sigmoid Diseases Adult Colon Colon Colon, Sigmoid Colon, Sigmoid Constipation Constipation Constipation Constipation Defecation Defecation Digestive System Surgical Procedures Digestive System Surgical Procedures Endometriosis Endometriosis

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