Bowel Function After Minimally Invasive Hysterectomy

  • End date
    Jun 30, 2023
  • participants needed
  • sponsor
    University of Chicago
Updated on 26 February 2022
polyethylene glycol 3350
postoperative constipation
Accepts healthy volunteers


Postoperative constipation affects up to a third of women undergoing minimally invasive (MIS) gynecologic surgery and is a major source of anxiety and discomfort. The average time to first bowel movement after gynecologic surgery is about 2 to 4 days and some factors responsible for this include anesthesia inhibitory effect on gastrointestinal motility, opioid pain medication use, chronic NSAID use and anatomic manipulation.

There are no established regimens to manage postoperative constipation after minimally invasive gynecologic surgery. Two studies evaluating the implementation of postoperative bowel regimen with polyethylene glycol (PEG) and with Senna and Docusate found no significant impact on postoperative bowel function. There have been no studies looking at the effect of preoperative bowel regimens on postoperative bowel function.

The purpose of this study is to evaluate postoperative bowel function after minimally invasive hysterectomy in women receiving a preoperative 10-day bowel regimen of PEG daily.


Following enrollment subjects will be randomized into the intervention/treatment arm and control arm. All subjects will be asked to complete a baseline demographic form and three questionnaires (PAC-SYM, PAC- QOL, Wexner Constipation score). Additional demographic information will be obtained from chart review. This information will include past medical history, use of constipating medications, use of daily pain medications, chronic pain history, use of daily fiber supplementation.

Subjects in the intervention arm will be given 10-day supply of Miralax and instructed on its use. They will take this medication for the 10 days prior to surgery. Subjects in the control arm will continue with standard care prior to surgery.

Post operatively, all subjects will complete a diary for 7 days. In this diary they will record details about their bowel movements (time of movement, discomfort, texture of stool). They will also report average daily pain levels ( with a visual analog scale), daily pain medication use (time, medication, total number of pills).

At the end of the 7th day all subjects will complete the same PAC questionnaires as they did pre-operatively.

Condition Constipation
Treatment Polyethylene Glycol 3350
Clinical Study IdentifierNCT04263896
SponsorUniversity of Chicago
Last Modified on26 February 2022


Yes No Not Sure

Inclusion Criteria

Any woman 18 years of age undergoing a minimally invasive hysterectomy (Laparoscopic, robotic, vaginal)
Able to understand the consenting process and willing to participate in study

Exclusion Criteria

Planned laparotomy
Emergent surgery
Regular preoperative use of PEG 3350, laxatives, enemas or suppositories
Planned bowel surgery
Presence of colostomy
Inability to consent
Medical problems as follows
CKD (Cr: > 1.2 mg/dL)
Cardiac disease
Gastric ulcers
Difficulty swallowing or esophageal stricture
Persistent nausea or vomiting
Signs or symptoms of a small bowel obstruction
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