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Symptoms of anal incontinence and difficult defecation among women with prolapse and a matched control cohort.

Abstract：

OBJECTIVE:The purpose of this study was to quantify the risk for anal incontinence and difficult defecation among women with prolapse by comparing them with women without prolapse of similar age, body mass index, race, and hysterectomy status, and to determine whether there are characteristics or findings in women with prolapse that are associated with greater symptom severity. STUDY DESIGN:Women with primary pelvic organ prolapse (n = 151) were compared with women without prolapse (n = 135). All subjects underwent pelvic examination and completed symptom questionnaires regarding how frequently anal incontinence and difficult defecation were experienced. Incontinence of flatus was considered to be present if it occurred on "most" or "every" day; difficult defecation was considered to be present if it was experienced with "most" or "every" bowel movement. Symptoms that occurred "on occasion" or "never" were considered to be absent. RESULTS:Incontinence of flatus was reported by 23.1% of cases vs 8.3% of control subjects (P = .006). Incontinence of liquid or solid stool was present in 4.7% and 3.5%, respectively, and was not reported by control subjects (P < .001 and .009, respectively). Difficult defecation, which was characterized by pushing on the vaginal walls to complete defecation, was present in 19.7% vs 4.4% of control subjects (P = .001). Cases that reported symptoms were compared with those that did not report symptoms. Among those reporting difficult defecation, the length of the perineal body length was greater when straining (4.0 vs 3.4 cm; P = .020). Among those reporting incontinence of flatus, mean parity was higher (3.3 vs 2.5; P = .012), and a positive standing cough stress test was more likely (39.3% vs 18.5%; P = .025). Symptoms of anal incontinence and/or difficult defecation were present in 35.3% of subjects (52/147). CONCLUSION:Women with prolapse are more likely than control subjects to have symptoms of anal incontinence or difficult defecation; approximately one-third of these women will have symptoms.

journal_name

Am J Obstet Gynecol

journal_title

American journal of obstetrics and gynecology

authors

Morgan DM,DeLancey JO,Guire KE,Fenner DE

doi

10.1016/j.ajog.2007.03.074

subject

Has Abstract

pub_date

2007-11-01 00:00:00

pages

509.e1-6

issue

eissn

0002-9378

issn

1097-6868

pii

S0002-9378(07)00472-3

journal_volume

197

pub_type

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Symptoms of anal incontinence and difficult defecation among women with prolapse and a matched control cohort.