Patient Expectations and Experiences With Postoperative Bowel Function

IMPORTANCE: Postoperative constipation can affect quality of life and satisfaction in patients undergoing urogynecologic surgery. OBJECTIVES: The objectives of this study were to compare preoperative expectations regarding postoperative bowel function to patients' actual experiences after surgery, and to examine patient-reported use and satisfaction with polyethylene glycol. STUDY DESIGN: This was a prospective cohort study of women undergoing urogynecologic surgery. Before surgery, participants were asked to complete a survey on baseline bowel function and postoperative bowel function expectations, which included the validated Wexner constipation questionnaire. Participants were again surveyed at 1 week and 6 weeks postoperatively regarding their experiences with postoperative bowel movements and use of polyethylene glycol. Patient Global Impressions of Improvement were used to measure postoperative improvement in bowel function. RESULTS: Of 86 enrolled participants, 83 (96.5%) completed the 1-week and 77 (89.5%) completed the 6-week follow-up. Some participants reported improvement in bowel movements at 1 week (53%), and more at 6 weeks (65%). Presence of preoperative concerns about first bowel movement did not influence perception of improvement at 1 week (55% vs 45%, respectively, P=0.33) or at 6 weeks (62.2% vs 52.5%, P=0.37). At 6 weeks, those who continued to use polyethylene glycol were more likely to report postoperative bowel improvement (84.4% vs 50%, P=0.002). CONCLUSIONS: Most patients experience improvement in bowel function after urogynecologic surgery. Preoperative concerns do not seem to affect self-reported improvement. Some patients taking polyethylene glycol experience improvement in bowel function as early as 1 week after urogynecologic surgery, with more improvement at 6 weeks.