Anorectal dysfunction in women with urinary incontinence or lower urinary tract symptoms

Ng, Soo‐Cheen; Chen, Y.-C.; Lin, Long-Yau; Chen, G.-D.

doi:10.1016/s0020-7292(02)00026-7

Cited by 33 publications

(25 citation statements)

References 21 publications

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“…Nevertheless, fecal impaction has been associated with overflow incontinence in previous studies [7,40] and should be taken into account when managing fecal incontinence in nursing home residents. Additionally, pelvic examination should be performed, especially when the resident has double incontinence, in order to identify possible prolapse or rectocele [41]. Cognitive and functional assessments are important to evaluate the resident’s ability to access and use the toilet.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and correlates of fecal incontinence among nursing home residents: a population-based cross-sectional study

et al. 2013

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BackgroundFecal incontinence is highly prevalent among nursing home residents. Previous nursing home studies have identified co-morbidity associated with fecal incontinence, but as this population is increasingly old and frail, we wanted to see if the rate of fecal incontinence had increased and to investigate correlates of fecal incontinence further.MethodsCross-sectional study of the entire nursing home population in one Norwegian municipality. Registered nurses filled in a questionnaire for all residents in the municipality (980 residents aged ≥65). Statistical methods used are descriptive statistics, binary logistic regression and multivariable logistic regression.ResultsThe response rate of the study was 90.3%. The prevalence of fecal incontinence was 42.3%. In multivariable analysis of FI, residents with diarrhea (OR 7.33, CI 4.39-12.24), urinary incontinence (OR 2.77, CI 1.73-4.42) and dementia (OR 2.17, CI 1.28-3.68) had higher odds of having fecal incontinence compared to those without the condition. Residents residing in a nursing home between 4–5 years had higher odds of having fecal incontinence compared to residents who had stayed under a year (OR 2.65, CI 1.20-5.85). Residents with deficiency in feeding (2.17, CI 1.26-3.71), dressing (OR 4.03, CI 1.39-11.65), toilet use (OR 7.37, CI 2.65-20.44) and mobility (OR 2.54, CI 1.07-6.00) had higher odds of having fecal incontinence compared to residents without deficiencies in activities of daily living (ADL). Needing help for transfer between bed and chair was a protective factor for fecal incontinence compared to residents who transferred independently (OR 0.49, CI 0.26-0.91).ConclusionsFecal incontinence is a prevalent condition in the nursing home population and is associated with ADL decline, frailty, diarrhea and quality of care. This knowledge is important for staff in nursing home in order to provide the best treatment and care for residents with fecal incontinence.

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Section: Discussionmentioning

confidence: 99%

Prevalence and correlates of fecal incontinence among nursing home residents: a population-based cross-sectional study

et al. 2013

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“…Utero‐vaginal prolapse is another condition that has been associated with both LUT symptoms and concomitant bowel symptoms. In an evaluation of 320 women with LUT symptoms, FI was found in 16% of patients and constipation in 32%, and prolapse was the principle risk factor for incontinence 19…”

Section: Clinical Co‐morbidity Of Bladder‐bowel Dysfunctionsmentioning

confidence: 99%

Do the urinary bladder and large bowel interact, in sickness or in health?: ICI‐RS 2011

Malykhina

Wyndaele

Andersson

et al. 2012

Neurourology and Urodynamics

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Normal functioning of the urinary bladder and the distal gut is an essential part of daily physiological activity coordinated by the peripheral and central nervous systems. Pathological changes in one of these organs may induce the development of cross-organ sensitization in the pelvis and underlie clinical co-morbidity of genitourinary and GI dysfunctions. Experimental human and animal data suggest that the bladder and distal colon interact under both normal and pathological conditions, however, the directions of these interactions can change dramatically depending on the nature and duration of the applied stimuli. This review article aimed to summarize the clinical data on colon-bladder cross-reflexes in healthy individuals, as well as in patients with co-morbid disorders. It also discusses currently used animal models, experimental approaches, and suggested mechanisms of colon-bladder cross-talk. Additionally, it provides an overview of the potential pharmacological targets to develop treatment options for patients with co-morbid disorders. Presented work resulted from the discussion of colon/bladder interactions during “Think Tank 9” presentations at the International Consultation on Incontinence Research Society meeting held in Bristol, UK, 2011.

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“…In past decades, some studies have demonstrated that the prevalence of anal incontinence (fecal and/or flatus incontinence) increases among women with urinary incontinence or urogynecological complaints [9][10][11]. These studies suggest that women with lower urinary tract symptoms or disorders might share some potential risk factors such as the effects of hypoestrogenization, genetics, concomitant damage, and dual innervations that would predispose them to the occurrence of anorectal dysfunctions.…”

Section: Introductionmentioning

confidence: 99%

Age effects on anorectal pressure in anal continent women with lower urinary tract dysfunction

Chen

2006

Int Urogynecol J

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The objective of this paper is to evaluate age and associated factors affecting anorectal pressure profilometry in anal-continent women with lower urinary tract symptoms. One hundred and ten anal-continent women (mean age, 47.7+/-12.8 years; range, 23-87 years) with lower urinary tract symptoms voluntarily participated in this study after undergoing a complete urogynecological evaluation including a multichannel urodynamic study. Anorectal pressure was evaluated by using a radial four-channel manometry with a water-filled catheter, which was placed 10 cm into the anorectum above the anal verge. We divided the anorectal pressure profile into five segments and four axes to clarify the axis-specific defect or site-specific damage in the sphincter profile. The aging process had a negative effect on the peak resting pressure from the 41 to 100th percentile of the anorectal pressure profile at 12 o'clock, 3 o'clock, and 6 o'clock (P<0.05). With voluntary squeezing, aging had negative effects on the peak squeeze pressure from the 41 to 100th percentile of the anorectal pressure profile at 3 o'clock, and 61 to 80 percentile at 12 o'clock (P<0.05). There is a trend where anorectal pressure reduces as a woman ages, especially at the anal sphincter area in women with lower urinary tract symptoms. The anterior and left sides of the anorectal sphincter seem to be the most vulnerable in the aging process.

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Anorectal dysfunction in women with urinary incontinence or lower urinary tract symptoms

Abstract: Our results demonstrate a relatively high prevalence of anal incontinence or constipation among women suffering from urinary dysfunction. Uterovaginal prolapse is the main risk factor associated with anorectal dysfunction.

Cited by 33 publications

References 21 publications

Prevalence and correlates of fecal incontinence among nursing home residents: a population-based cross-sectional study

Prevalence and correlates of fecal incontinence among nursing home residents: a population-based cross-sectional study

Do the urinary bladder and large bowel interact, in sickness or in health?: ICI‐RS 2011

Age effects on anorectal pressure in anal continent women with lower urinary tract dysfunction

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