Concurrent total abdominal colectomy and ileorectal anastomosis with transvaginal posterior colporrhaphy for constipation

  • Peter Chia YehEmail author
  • Francisco Orejuela
  • Lisa Haubert
Images in Urogynecology


Constipation, one of the most commonly encountered gastrointestinal disorders, is associated with impaired quality of life and a large economic burden. Studies estimate the prevalence of constipation in the general population to be 12–19% and up to 30–40% among people >65 years of age [1, 2]. The high rate of recurrence of constipation in the elderly can result in fecal impaction, stercoral ulcers, and volvulus [3]. Constipation can be categorized as slow-transit constipation, normal-transit constipation, or obstructed defecation, with diagnoses occurring separately or in combination [4]. Patients with severe slow-transit constipation have an increased risk of pelvic organ prolapse (POP) due to chronic straining. Prior to surgical correction of the prolapse, it is necessary to address the underlying risk factors, such as slow-transit constipation, often with a separate subtotal or total colectomy [4, 5, 6]. We report a case of a patient with a longstanding history of...


Slow-transit constipation Rectocele Total abdominal colectomy Transvaginal posterior colporrhaphy 


Compliance with ethical standards

Conflicts of interest



Written informed consent was obtained from the patient for publication of this case report and any accompanying images.


  1. 1.
    Higgins PD, Johanson JK. Epidemiology of constipation in North America: a systematic review. Am J Gastroenterol. 2004;99:750–9.CrossRefGoogle Scholar
  2. 2.
    Dennison C, Prasad M, Lloyd A, Bhattacharyya SK, Dhawan R, Coyne K. The health-related quality of life and economic burden of constipation. Pharmacoeconomics. 2005;23(5):461–76.CrossRefGoogle Scholar
  3. 3.
    Gallegos-Orozco JF, Foxx-Orenstein AE, Sterler SM, Stoa JM. Chronic constipation in the elderly. Am J Gastroenterol. 2012;107:18–25.CrossRefGoogle Scholar
  4. 4.
    Steele SR, Mellgren A. Constipation and obstructed defecation. Clin Colon Rectal Surg. 2007;20(2):110–7.CrossRefGoogle Scholar
  5. 5.
    Sohn G, Yu CS, Kim CW, et al. Surgical outcomes after total colectomy with ileorectal anastomosis in patients with medically intractable slow transit constipation. J Korean Soc Coloproctol. 2011;27(4):180–7.CrossRefGoogle Scholar
  6. 6.
    Yu S, Deng JZ, Peng X, et al. Comparison of laparoscopic subtotal colectomy with posterior vaginal suspension and laparoscopic subtotal colectomy with transvaginal repair for patients with slow-transit constipation complicated with rectocele: a non-randomized comparative study in a single center. Surg Endosc. 2016;30:2759–65.CrossRefGoogle Scholar

Copyright information

© The International Urogynecological Association 2019

Authors and Affiliations

  1. 1.Baylor College of MedicineHoustonUSA
  2. 2.Department of Obstetrics and GynecologyBaylor College of MedicineHoustonUSA
  3. 3.Department of General SurgeryBaylor College of MedicineHoustonUSA

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