Effect of Female Gender and Hysterectomy on Colonoscopy Procedure Time

Abstract

Purpose: Some feel that female anatomy and post-surgical changes with hysterectomy affect colonoscopy by increasing cecal intubation time. However, there are no studies directly comparing females to males. We sought to prospectively determine the effect of female gender and hysterectomy on colonoscopy procedure time. Methods: We enrolled and compared the 1st consecutive 60 males (Grp 1), 40 females w/o hysterectomy (Grp 2), and 20 females w/hysterectomy (Grp 3) undergoing screening colonoscopy, starting from October 1, 2007. We collected data on patient characteristics (age, BMI, ethnicity, previous colonoscopy, co-morbid medical conditions) and endoscopy characteristics (level of experience of endoscopist, # biopsies/polypectomies performed, dose of versed/fentanyl used). We collected data on total procedure, cecal intubation, scope withdrawal, and recovery times. Results: In our study, pts were comparable for age, BMI, prev colonoscopy, % co-morbid medical conditions, % 1st yr GI fellow performing procedure, and total dose of versed/fentanyl given. There was a significantly higher proportion of Caucasian pts in the male group compared to female groups. There was no significant difference between the 3 groups for cecal intubation time. On univariate analysis, women w/o hysterectomy had significantly shorter total procedure times; however, this group had significantly fewer polypectomies and biopsies performed during their procedure. Recovery time was significantly shorter in male pts. Total procedure time was predicted by formula: total colonoscopy procedure time (min) = 22.9 + 4.8 (if 1st yr GI fellow as endoscopist) + 7.2 (# polypectomies) + 2.3 (# biopsies). Female gender and history of hysterectomy were not found to be independent predictors of total procedure time. Conclusion: In our study, there was no difference between the 3 groups for cecal intubation time. We found that the level of experience of the endoscopist, # polypectomies performed, and # biopsies performed were independent predictors of total colonoscopy procedure time. Female gender and history of hysterectomy were not independent predictors of total colonoscopy procedure time. Larger studies are needed.Table: Results.