Determining Levels of Fecal Incontinence in the Community: A New Zealand Cross-Sectional Study

Sharma, Amit; Marshall, Roger; Macmillan, Alexandra; Merrie, Arend E. H.; Reid, P.; Bissett, Ian P.

doi:10.1097/dcr.0b013e31822dd0f0

Cited by 37 publications

(39 citation statements)

References 26 publications

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“…The prevalence of UI increases with age and is highly prevalent in the elderly and those with cognitive impairment [5]. Fecal incontinence (FI) occurs in up to 6% of those younger than 40 years increasing to 15% in older individuals [1, 2, 4]. Combined FI and UI has been reported in 10% of women and in 6–10% of men living in the community, increasing to almost 50% in nursing home residents [7–9].…”

Section: Introductionmentioning

confidence: 99%

Can incontinence be cured? A systematic review of cure rates

Riemsma

Hagen

Kirschner‐Hermanns³

et al. 2017

BMC Med

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BackgroundIncontinence constitutes a major health problem affecting millions of people worldwide. The present study aims to assess cure rates from treating urinary (UI) or fecal incontinence (FI) and the number of people who may remain dependent on containment strategies.MethodsMedline, Embase, PsycINFO, Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, and PEDro were searched from January 2005 to June 2015. Supplementary searches included conference abstracts and trials registers (2013–2015). Included studies had patients ≥ 18 years with UI or FI, reported treatment cure or success rates, had ≥ 50 patients treated with any intervention recognized in international guideline algorithms, a follow-up ≥ 3 months, and were published from 2005 onwards. Title and abstract screening, full paper screening, data extraction and risk-of-bias assessment were performed independently by two reviewers. Disagreements were resolved through discussion or referral to a third reviewer where necessary. A narrative summary of included studies is presented.ResultsMost evidence was found for UI: Surgical interventions for stress UI showed a median cure rate of 82.3% (interquartile range (IQR), 72–89.5%); people with urgency UI were mostly treated using medications (median cure rate for antimuscarinics = 49%; IQR, 35.6–58%). Pelvic floor muscle training and bulking agents showed lower cure rates for UI. Sacral neuromodulation for FI had a median cure rate of 38.6% (IQR, 35.6–40.6%).ConclusionsMany individuals were not cured and hence may continue to rely on containment. No studies were found assessing success of containment strategies. There was a lack of data in the disabled and in those with neurological diseases, in the elderly and those with cognitive impairment. Surgical interventions were effective for stress UI. Other interventions for UI and FI showed lower cure rates. Many individuals are likely to be reliant on containment strategies.PROSPERO RegistrationPROSPERO registration number: CRD42015023763.Electronic supplementary materialThe online version of this article (doi:10.1186/s12916-017-0828-2) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Can incontinence be cured? A systematic review of cure rates

Riemsma

Hagen

Kirschner‐Hermanns³

et al. 2017

BMC Med

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“…6,7 It is thought that prevalence may be underestimated because patients are often reluctant to report their symptoms. 8 Australian, 8 New Zealand, 9 Spanish, 10 and Korean 11 studies have reported prevalence rates of 15%, 12.4%, 10.8%, and 6.4% respectively, for random samples drawn from the general population. Although prevalence in women is thought to be higher than in men, 4 usually as a consequence of childbirth-related injuries, [12][13][14] some studies have failed to find clear epidemiological differences between the sexes, whereas other studies have actually reported higher prevalence rates for men than for women.…”

Section: Introductionmentioning

confidence: 99%

Quality of Life Differences in Female and Male Patients with Fecal Incontinence

Mundet

Ribas

Arco

et al. 2015

J Neurogastroenterol Motil

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Background/AimsTo explore and compare quality of life (QoL) differences in female and male patients with fecal incontinence. MethodsNinety-one patients with fecal incontinence (60 women, mean (SD) age 64.13 (9.72) years; 31 men, mean (SD) age 63.61 (13.33) years) were assessed for pathophysiology (anorectal manometry and ultrasound), clinical severity (Wexner and Vaizey scales), QoL (Fecal Incontinence Quality of Life Score [FIQL]) and health status (EQ-5D). ResultsExternal and internal anal sphincter impairment rates were 96.5% and 70.2%, respectively, in women, compared to 30% and 43.3% respectively in men (P < 0.05). Clinical severity was similar in both sexes, with mean (SD) Wexner scores of 10.95 (4.35) for women and 9.81 (4.30) for men, and mean (SD) Vaizey scores of 13.27 (4.66) for women and 11.90 (5.22) for men. Scores for women were significantly lower for all FIQL depression and coping subscales (P < 0.001) and the EQ-5D depression subscale (P < 0.01). EQ-5D index was 0.687 (0.20) for women and 0.835 (0.15) for men (P < 0.001). QoL was negatively affected by female gender (-1.336), anxiety/depression (-1.324) and clinical severity (-0.302), whereas age had a positive impact (0.055 per year) (P < 0.01). ConclusionsThe pathophysiology of fecal incontinence differed between the sexes. For similar severity scores, impact on QoL was higher in women. Gender had the highest impact on QoL compared to other factors. QoL measurements should be part of assessment and treatment protocols.

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“…[1] AI results in emotional, psychological and social problems. [2][3][4] Mechanical sphincter disruption and nerve damage occurring as a complication of childbirth contribute to the development of AI. [2][3][4][5][6][7] Studies suggest that obstetric factors increase the risk of damage to the anal sphincter and subsequent development of AI.…”

mentioning

confidence: 99%

“…[2][3][4] Mechanical sphincter disruption and nerve damage occurring as a complication of childbirth contribute to the development of AI. [2][3][4][5][6][7] Studies suggest that obstetric factors increase the risk of damage to the anal sphincter and subsequent development of AI. [4][5][6] These include a prolonged second stage of labour, fetal macrosomia, posterior positions of the fetal skull, instrumental delivery, epidural analgesia, episiotomy and, most significantly, rupture of the anal sphincter.…”

mentioning

confidence: 99%

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Postpartum anal incontinence in a resource-constrained setting: Prevalence and obstetric risk factors

Naidoo¹,

Moodley²

2014

S Afr J OG

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Anal incontinence (AI) is defined as involuntary loss of faeces or flatus. Faecal incontinence is defined as a complaint of involuntary loss of solid or liquid faeces, while flatal incontinence is defined as a complaint of involuntary loss of flatus. [1] AI results in emotional, psychological and social problems. [2][3][4] Mechanical sphincter disruption and nerve damage occurring as a complication of childbirth contribute to the development of AI. [2][3][4][5][6][7] Studies suggest that obstetric factors increase the risk of damage to the anal sphincter and subsequent development of AI. [4][5][6] These include a prolonged second stage of labour, fetal macrosomia, posterior positions of the fetal skull, instrumental delivery, epidural analgesia, episiotomy and, most significantly, rupture of the anal sphincter. [2,4,7] Determining the true incidence of AI is often difficult, because women rarely volunteer information about symptoms unless specifically asked. [3][4][5] Variations in definitions, underlying causes and subjectivity of symptoms also impact on the incidence. [3,4] Furthermore many women only present with symptoms after the puerperium, or later.Prevalence rates vary from 13% to 44% between 6 weeks and 10 months after delivery in primiparous and multiparous women. [3][4][5] Up to 25% of primigravidas experience altered continence postnatally, with one-third having evidence of anal sphincter injury. [4,5] Most of the published data on AI involve studies performed on white women in high-income countries. There are minimal data from low-and middle-income countries (LMICs) like ours, where socioeconomic, demographic, racial, anatomical and histological variations may impact on obstetric risk factors and AI prevalence. We therefore performed a study in our population, which consists mainly of Zulu-speaking black Africans and Indians.The aim was to describe the prevalence of AI in our population antenatally and 6 weeks and 6 months after vaginal delivery or emergency caesarean section (CS) in late labour, and to explore the association between demographic and obstetric risk factors and AI. MethodsThis prospective observational study was conducted at two regional hospitals (King Edward VIII Hospital and R K Khan Hospital) servicing the lower socioeconomic groups of the Durban metropolitan area in KwaZulu-Natal Province, South Africa.Women delivering vaginally or by emergency CS late in labour (N=1 254) were recruited over a 3-month period and followed up for 6 months. Participants completed a standardised AI symptom questionnaire on 3 occasions: antenatally or within 24 hours of delivery (information on the antenatal period), and 6 weeks and 6 months after delivery. The antenatal questionnaire was administered Postpartum anal incontinence in a resource-constrained setting: Prevalence and obstetric risk factorsBackground. Postpartum anal incontinence (AI) is a common and debilitating condition, but data from resource-constrained settings are scarce. Objective. To show that AI is common in a resource-constrained...

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Determining Levels of Fecal Incontinence in the Community: A New Zealand Cross-Sectional Study

Cited by 37 publications

References 26 publications

Can incontinence be cured? A systematic review of cure rates

Can incontinence be cured? A systematic review of cure rates

Quality of Life Differences in Female and Male Patients with Fecal Incontinence

Postpartum anal incontinence in a resource-constrained setting: Prevalence and obstetric risk factors

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