Hysterectomy Does Not Cause Constipation

PURPOSE This study was designed to evaluate the risk on development and persistence of constipation after hysterectomy. METHODS We conducted a prospective, observational, multicenter study with three-year follow-up in 13 teaching and nonteaching hospitals in The Netherlands. A total of 413 females who underwent hysterectomy for benign disease other than symptomatic uterine prolapse were included. All patients underwent vaginal hysterectomy, subtotal abdominal hysterectomy, or total abdominal hysterectomy. A validated disease-specific quality-of-life questionnaire was completed before and three years after surgery to assess the presence of constipation. RESULTS Of the 413 included patients, 344 (83 percent) responded at three-year follow-up. Constipation had developed in 7 of 309 patients (2 percent) without constipation before surgery and persisted in 16 of 35 patients (46 percent) with constipation before surgery. Preservation of the cervix seemed to be associated with an increased risk of the development of constipation (relative risk, 6.6; 95 percent confidence interval, 1.3-33.3; P = 0.02). Statistically significant risk factors for the persistence of constipation could not be identified. CONCLUSIONS Hysterectomy does not seem to cause constipation. In nearly half of the patients reporting constipation before hysterectomy, this symptom will disappear.