Bowel Management Key to Pelvic Reconstruction.

VAIL, COLO. -- Two highly underestimated ways of maximizing the results of pelvic reconstructive surgery are aggressive bowel management and tight restrictions on load lifting and exercise, Dr. Nicolette S. Horbach said at a conference on obstetrics and gynecology sponsored by the University of Colorado.

It's important to take a history about bowel function and aggressively manage chronic constipation preoperatively, because when a woman strains for 2-5 minutes while moving her bowels in the initial postoperative period, the repair will be weakened and the risk of failure will increase, according to Dr. Horbach, immediate past president of the American Urogynecological Society.

Don't hesitate to maintain the use of stool softeners for months and years following surgery if need be, said Dr. Horbach, an ob.gyn. at George Washington University Washington, D.C.

Restricting both lifting and exercise following surgery for incontinence and/or prolapse is as important as after spinal disk surgery. The restriction helps the patient attain adequate scar formation.

Because tissue healing requires 6 months, Dr. Horbach said she recommends no work outside the home for a minimum of 2 months and no ...