A Systematic Review of Fecal Incontinence after Hysterectomy
Background: Hysterectomies can substantially affect sexual and gynecological health. Fecal incontinence (FI) is a known complication of hysterectomy that is often overlooked. Objectives: This systematic review evaluates the effect of hysterectomy on long-term bowel function. Design, Settings, Patien...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2025-04-01
|
| Series: | World Journal of Colorectal Surgery |
| Subjects: | |
| Online Access: | https://journals.lww.com/wjcs/fulltext/2025/04000/a_systematic_review_of_fecal_incontinence_after.4.aspx |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Summary: | Background:
Hysterectomies can substantially affect sexual and gynecological health. Fecal incontinence (FI) is a known complication of hysterectomy that is often overlooked.
Objectives:
This systematic review evaluates the effect of hysterectomy on long-term bowel function.
Design, Settings, Patients, and Methods:
A systematic search in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed for studies published after 2000 on women who had undergone hysterectomies and developed fecal incontinence (FI).
Main Outcome Measures:
The primary outcome was FI incidence. The secondary outcomes were FI evaluation metric, hysterectomy characteristics, and demographic factors.
Results:
A total of 424 articles were identified in the initial screening, of which 23 were included in this study. Of the 5,104 patients who underwent hysterectomies, 95.5% (n = 4,874) were assessed for FI. Of this cohort, 13.7% (n = 670) developed FI. The average frequency of FI development based on incidence in individual studies was 10.3% (95% confidence interval (CI) [7.8, 12.7]). The average age of the patients was 48.1 years (95% CI [46.7, 49.5]), average BMI was 25.7 kg/m2 (95% CI [24.5, 26.9]), and average follow-up duration was 43.4 months (95% CI [28.5, 58.3]). These variables were reported by 19 (82.6%), 10 (43.5%), and 18 (78.3%) of the 23 included studies, respectively. The reporting of the other secondary outcomes varied widely across the studies.
Conclusions and Limitations:
This review presents a wide range of data on FI following hysterectomy. Owing to nonuniformity between the studies, there were no consistent accounts of patient history, nor a common, validated FI evaluation metric. FI was found in 13.8% of the patients following hysterectomy. Therefore, education regarding this potential complication should be a part of the routine hysterectomy consent process. Limitations include the wide variety of information reported in the included studies.
Conflict of Interest:
None. |
|---|---|
| ISSN: | 1941-8213 |