Pre-operative Bowel Preparation Prior to Minimally Invasive Sacral Colpopexy

Prior to surgery, gynecologists and urogynecologists have routinely prescribed preoperative
mechanical bowel preparations in attempts to decrease the risk of infection, while also
providing easier bowel manipulation and better visualization during surgery. However, many of
these proposed benefits have never been proven, and usage of bowel preparations amongst
surgeons remains highly variable. In both the general surgery and gynecology literature,
researchers have begun to question the need for the vigorous preparations.

Aside from surgical visualization, urogynecologists have additional concerns about how bowel
preparations may impact postoperative bowel function given up to half of women with pelvic
floor disorders have baseline constipation and straining is known to impact surgical
recovery. Many studies have addressed various postoperative fiber and laxative preparations
in attempts to improve postoperative bowel-related symptomatology, but none have specifically
looked at preoperative bowel preparations.

This study aims to determine if mechanical bowel preparation prior to minimally invasive
sacral colpopexy affects patients' postoperative recovery, specifically related to bowel
symptomatology; operative or post-operative complications; surgeons' perceptions of surgical
difficulty directly attributed to the bowel; and post-operative return of normal bowel
function.