Gutman Robert E, Bradley Catherine S, Ye Wen, Markland Alayne D, Whitehead William E, Fitzgerald Mary P
Department of Obstetrics and Gynecology, Washington Hospital Center, Washington, DC, USA.
Int Urogynecol J. 2010 Apr;21(4):461-6. doi: 10.1007/s00192-009-1062-z. Epub 2009 Dec 4.
Our objective was to evaluate bowel symptoms after colpocleisis.
This was a planned ancillary analysis of a prospective, colpocleisis cohort study of 152 women. Those with baseline and 1-year questionnaires (Colorectal-Anal Distress Inventory (CRADI) and the Colorectal-Anal Impact Questionnaire (CRAIQ)) were included. "Bothersome" CRADI symptoms (score>2("moderately", "quite a bit")) were identified. CRADI and CRAIQ scores were compared, and postoperative symptom resolution and new symptom development were measured.
Of 121 (80%) subjects with complete data, mean age was 79.2 +/- 5.4 years and all had stage 3-4 prolapse. Procedures performed: partial colpocleisis (61%), total colpocleisis (39%), levator myorrhaphy (71%), and perineorrhaphy (97%). Bothersome bowel symptom(s) were present in 77% at baseline (obstructive (17-26%), incontinence (12-35%) and pain/irritation (3-34%)). All bothersome obstructive and most bothersome incontinence symptoms were less prevalent 1 year after surgery. CRADI and CRAIQ scores significantly improved. The majority of bothersome symptoms resolved (50-100%) with low rates of de novo symptoms (0-14%).
Most bothersome bowel symptoms resolve after colpocleisis, especially obstructive and incontinence symptoms, with low rates of de novo symptoms.
我们的目标是评估阴道封闭术后的肠道症状。
这是一项对152名女性进行的前瞻性阴道封闭队列研究的计划辅助分析。纳入那些有基线和1年问卷（结直肠-肛门困扰量表（CRADI）和结直肠-肛门影响问卷（CRAIQ））的患者。确定“困扰性”CRADI症状（评分>2（“中度”，“相当多”））。比较CRADI和CRAIQ评分，并测量术后症状缓解情况和新症状的出现情况。
在121名（80%）有完整数据的受试者中，平均年龄为79.2±5.4岁，均患有3 - 4期脱垂。所进行的手术：部分阴道封闭术（61%）、全阴道封闭术（39%）、提肌修补术（71%）和会阴修补术（97%）。基线时77%的患者存在困扰性肠道症状（梗阻性（17 - 26%）、失禁（12 - 35%）和疼痛/刺激（3 - 34%））。术后1年，所有困扰性梗阻症状和大多数困扰性失禁症状的发生率均降低。CRADI和CRAIQ评分显著改善。大多数困扰性症状得到缓解（50 - 100%），新症状发生率较低（0 - 14%）。
阴道封闭术后大多数困扰性肠道症状得到缓解，尤其是梗阻性和失禁症状，新症状发生率较低。
