A randomized controlled trial on bowel preparation for patients undergoing vaginal prolapse surgery
Jean Aileen E. Manalastas, Joanne Karen S. AguinaldoAbstract:
INTRODUCTION:
Bowel preparation is commonly done to improve surgical field visualization and ease of bowel handling and to decrease the risk of fecal contamination during a bowel injury. Recent studies challenge the routine use of bowel preparation for vaginal prolapse surgery.
OBJECTIVE:
The objective was to determine whether bowel preparation using a 2-day low-residue diet with the administration of bisacodyl would improve the quality of the surgical field.
MATERIALS AND METHODS:
This was a single-blind randomized trial conducted among women undergoing vaginal prolapse surgery in a tertiary hospital. Sixty women were randomized, 30 to the bowel preparation group (2-day low-residue diet with laxative) and 30 to the no bowel preparation group. The primary outcome was the surgeons’ intraoperative assessment of the surgical field.
RESULTS:
There were no significant differences between the two groups in terms of age, severity of prolapse, surgical procedure, type of anesthesia, blood loss, or operative time. No bowel injuries were incurred in either group. The overall assessment of the acceptability of the surgical field was comparable between the bowel preparation group and the no bowel preparation group. There was no significant difference between the two groups in terms of adequacy of visualization, presence of stool in the rectal vault, intraoperative stooling, and ease of bowel handling. Reports of hunger were greater in the bowel preparation group, whereas the other bowel symptoms were not significantly different.
CONCLUSION:
This study showed that bowel preparation using a specified low-residue diet with bisacodyl administration offered no advantage over no preoperative bowel preparation to improve the acceptability of the operative field in vaginal prolapse surgery.