{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T15:26:20Z","timestamp":1746458780782},"reference-count":41,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2000,1,1]],"date-time":"2000-01-01T00:00:00Z","timestamp":946684800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2000,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Constipation after hysterectomy has been postulated to be due to pelvic nerve damage, but there may be emotional or reversible physical factors of pathophysiological relevance. The aim of this study was to determine whether such constipation is responsive to behavioural treatment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Three groups of patients who had completed a course of biofeedback treatment were compared: women with no history of abdominal or pelvic surgery (n = 25), women for whom a hysterectomy had led to no change in bowel function (n = 27) and women who stated that their constipation was precipitated (n = 18) or severely worsened (n = 8) by hysterectomy. Pretreatment and post-treatment details about bowel function and symptoms were assessed using structured interview, and pretreatment whole-gut transit time and anorectal physiology testing were assessed for prognostic relevance.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Follow-up after completing treatment was a median of 28 (range 12\u201344) months. Forty-eight of 78 patients considered that their constipation had improved with treatment; the proportion in each group was similar (P = 0\u00b773). Biofeedback reduced the need to strain, reduced abdominal pain, improved bowel frequency, and reduced laxative use to a similar degree in all three groups. Thirty-three of 53 patients with slow transit considered there was an improvement, compared with 15 of 22 with measured normal transit. Physiological testing did not predict outcome and did not differ between the three groups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The majority of patients complaining of constipation induced or worsened by hysterectomy respond subjectively to behavioural treatment, in a similar proportion to those with idiopathic constipation. In contrast to the widely held view that nerve damage is responsible for symptoms, reversible factors are likely to be important in many patients.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1046\/j.1365-2168.2000.01324.x","type":"journal-article","created":{"date-parts":[[2003,3,11]],"date-time":"2003-03-11T07:11:16Z","timestamp":1047366676000},"page":"100-105","source":"Crossref","is-referenced-by-count":18,"title":["Behavioural treatment (biofeedback) for constipation following hysterectomy"],"prefix":"10.1093","volume":"87","author":[{"given":"A J","family":"Roy","sequence":"first","affiliation":[{"name":"St Mark's Hospital , Northwick Park, Watford Road, Harrow HA1 3UJ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A V","family":"Emmanuel","sequence":"additional","affiliation":[{"name":"St Mark's Hospital , Northwick Park, Watford Road, Harrow HA1 3UJ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J B","family":"Storrie","sequence":"additional","affiliation":[{"name":"St Mark's Hospital , Northwick Park, Watford Road, Harrow HA1 3UJ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Bowers","sequence":"additional","affiliation":[{"name":"St Mark's Hospital , Northwick Park, Watford Road, Harrow HA1 3UJ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M A","family":"Kamm","sequence":"additional","affiliation":[{"name":"St Mark's Hospital , Northwick Park, Watford Road, Harrow HA1 3UJ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2000,1,1]]},"reference":[{"key":"2024093005070323000_bib1","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1016\/0277-9536(88)90289-4","article-title":"Do British women undergo too many or too few hysterectomies?","volume":"27","author":"Coulter","year":"1988","journal-title":"Soc Sci Med"},{"key":"2024093005070323000_bib2","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.1111\/j.1471-0528.1966.tb06130.x","article-title":"The late effects of Wertheim's hysterectomy on the urinary tract","volume":"73","author":"Fraser","year":"1966","journal-title":"Journal of Obstetrics and Gynaecology of the British Commonwealth"},{"key":"2024093005070323000_bib3","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1111\/j.1464-410X.1969.tb09978.x","article-title":"The urological complications of Wertheim's hysterectomy","volume":"41","author":"Smith","year":"1969","journal-title":"Br J Urol"},{"key":"2024093005070323000_bib4","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1016\/0002-9378(80)90132-5","article-title":"The effect of radical hysterectomy on bladder physiology","volume":"138","author":"Forney","year":"1980","journal-title":"Am J Obstet Gynecol"},{"key":"2024093005070323000_bib5","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1111\/j.1464-410X.1976.tb06676.x","article-title":"Urinary symptoms and total hysterectomy","volume":"48","author":"Jequier","year":"1976","journal-title":"Br J Urol"},{"key":"2024093005070323000_bib6","doi-asserted-by":"crossref","first-page":"141","DOI":"10.3109\/00016348809004187","article-title":"Micturition symptoms and urinary incontinence after non-radical hysterectomy","volume":"67","author":"Vervest","year":"1988","journal-title":"Acta Obstet Gynecol Scand"},{"key":"2024093005070323000_bib7","doi-asserted-by":"crossref","first-page":"1342","DOI":"10.1007\/BF02050820","article-title":"Changes in bowel function after hysterectomy","volume":"40","author":"van Dam","year":"1997","journal-title":"Dis Colon Rectum"},{"key":"2024093005070323000_bib8","doi-asserted-by":"crossref","first-page":"1820","DOI":"10.1007\/BF01536698","article-title":"Irritable bowel syndrome in the gynecological clinic. 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