ArticleWorld journal of urology2025
Prophylactic laxative use for postoperative constipation in urological cancer: a real-world cohort study.
Article in World journal of urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo assess the effectiveness of prophylactic laxative use compared to symptom-based management for preventing constipation in patients undergoing surgery for urological cancers.
methodsOf 2,024 screened patients (aged 18-80) with urological tumors, 1,724 eligible (no severe gastrointestinal disease, non-pregnant, scheduled for surgery) were non-randomly assigned to prevention (prophylactic laxatives, n = 965) or non-prevention groups (symptom-based, n = 748). Propensity score matching with a 1:1 optimal matching strategy was used to minimize baseline differences between the two groups. The primary outcome was the incidence of constipation within 7 days post-surgery. Secondary outcomes included complete spontaneous bowel movements (CSBM), patient assessment of constipation quality of life (PAC-QOL) scores, and patient assessment of constipation symptoms (PAC-SYM) scores at 7 days post-surgery. A nomogram was developed for predicting postoperative constipation.
resultsCompared to non-prevention, the incidence of postoperative constipation was significantly lower in the prevention group (12.3% vs. 42.7%; HR 0.24, 95% CI: 0.19-0.30, P < 0.001). A higher proportion of patients in the prevention group achieved ≥ 3 CSBMs per week ( 96.0% vs. 88.2%, P < 0.001), and PAC-SYM mean difference (MD = - 0.56, 95% CI: -0.79 to - 0.33) and PAC-QOL (MD = - 1.22, 95% CI: -2.03 to - 0.41) scores were improved. Age, constipation diagnosis, prophylactic laxative use, and baseline CSBM were identified as independent risk factors for postoperative constipation.
conclusionProphylactic laxative use was associated with a significantly lower incidence of postoperative constipation in patients with urological tumors. Our findings offer preliminary evidence for clinicians in identifying patients at risk of developing postoperative constipation.
trial registrationChiCTR2100042876 ( www.chictr.org.cn ).
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