Bowel Function After Minimally Invasive Hysterectomy

Last updated: October 29, 2024
Sponsor: University of Chicago
Overall Status: Active - Recruiting

Phase

4

Condition

Constipation

Treatment

Polyethylene Glycol 3350

Clinical Study ID

NCT04263896
IRB19-0436
  • Ages > 18
  • Female
  • Accepts Healthy Volunteers

Study Summary

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.

Eligibility Criteria

Inclusion

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

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)

  • IDDM

  • Cardiac disease

  • Gastric ulcers

  • Difficulty swallowing or esophageal stricture

  • Persistent nausea or vomiting

  • Signs or symptoms of a small bowel obstruction

Study Design

Total Participants: 101
Treatment Group(s): 1
Primary Treatment: Polyethylene Glycol 3350
Phase: 4
Study Start date:
August 28, 2019
Estimated Completion Date:
June 30, 2025

Study Description

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.

Connect with a study center

  • University of Chicago Medicine

    Chicago, Illinois 60637
    United States

    Active - Recruiting

Not the study for you?

Let us help you find the best match. Sign up as a volunteer and receive email notifications when clinical trials are posted in the medical category of interest to you.