The long-term prevalence of anal incontinence in women with and without obstetric anal sphincter injuries

Everist, Rebecca; Burrell, Madeline; Parkin, Katrina; Patton, Vicki; Karantanis, Emmanuel

doi:10.1016/j.cont.2022.100571

Cited by 2 publications

(1 citation statement)

References 26 publications

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“…All levels of PFD reported were high compared with other studies: UI was reported by 40% of women in a 2015 UK survey [ 16 ] compared with 70% of our participants, and AI was reported by only 14% of women in a US epidemiological survey [ 25 ] compared with 48% in this survey. However, a recent study investigating the long-term effects of sphincter injuries at birth on AI reported 60% prevalence of AI in the control group (those without sphincter injury) [ 26 ] and this level was similar to that found in a group of young, nulliparous women [ 12 ]. Levels of POP again appear to be greater than that reported in the US epidemiological study [ 25 ] but in another recent internet-based survey, 14% of participants reported POP [ 13 ] compared with 18% of our respondents.…”

Section: Discussionsupporting

confidence: 70%

Prevalence of pelvic floor dysfunction in recreational athletes: a cross-sectional survey

2023

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Introduction and hypothesis Pelvic floor dysfunction (PFD) affects many women and participation in elite sport and high-impact exercise has been reported as a potential risk. However, few studies have investigated the effects of exercising at recreational levels on PFD. Our aim was to investigate levels of PFD in women exercising at, or above, UK guidelines for health and compare them with levels in non-exercisers. Method Data on levels of PFD and potential risk factors (age, hormonal status, body mass index, constipation, parity, forceps delivery, and recreational exercise) were collected using a cross-sectional survey distributed via social media. The International Consultation Incontinence Questionnaire (ICIQ) Urinary Incontinence Short Form was used to estimate prevalence of urinary incontinence (UI). Selected questions from the ICIQ vaginal symptom and bowel symptom questionnaires were used to estimate prevalence of anal incontinence (AI) and pelvic organ prolapse (POP). Logistic regression analysis was used to compare exercisers and non-exercisers after adjusting for potential confounders. Results We recruited 1,598 adult women (1,141 exercisers and 457 non-exercisers). The majority were parous. High prevalence of UI (70%), AI (52%) and POP (18%) was reported. No significant association was found between recreational exercise and PFD despite adjustment for confounders, or further investigation regarding exercise involving impact, although some increased reporting of AI was seen in those exercising for over 10 hours per week. Conclusion High levels of all PFD were reported but no significant association was found between recreational exercise and symptoms. However, data suggest that women modify their exercise regimes as required. Few symptomatic women sought professional help.

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Section: Discussionsupporting

confidence: 70%

Prevalence of pelvic floor dysfunction in recreational athletes: a cross-sectional survey

2023

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Caesarean section and anal incontinence in women after obstetric anal sphincter injury: A systematic review and meta‐analysis

Carter,

Hall,

Ajoku

et al. 2024

BJOG

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BackgroundApproximately 50% women who give birth after obstetric anal sphincter injury (OASI) develop anal incontinence (AI) over their lifetime.ObjectiveTo evaluate current evidence for a protective benefit of planned caesarean section (CS) to prevent AI after OASI.Search StrategyMEDLINE/PubMed, Embase 1974–2024, CINAHL and Cochrane to 7 February 2024 (PROSPERO CRD42022372442).Selection CriteriaAll studies reporting outcomes after OASI and a subsequent birth, by any mode.Data Collection and AnalysisEighty‐six of 2646 screened studies met inclusion criteria, with nine studies suitable to meta‐analyse the primary outcome of ‘adjusted AI’ after OASI and subsequent birth. Subgroups: short‐term AI, long‐term AI, AI in asymptomatic women. Secondary outcomes: total AI, quality of life, satisfaction/regret, solid/liquid/flatal incontinence, faecal urgency, AI in women with and without subsequent birth, change in AI pre‐ to post‐ subsequent birth.Main ResultsThere was no evidence of a difference in adjusted AI after subsequent vaginal birth compared with CS after OASI across all time periods (OR = 0.92, 95% CI 0.72–1.20; 9 studies, 2104 participants, I2 = 0% p = 0.58), for subgroup analyses or secondary outcomes. There was no evidence of a difference in AI in women with or without subsequent birth (OR = 1.00 95% CI 0.65–1.54; 10 studies, 970 participants, I2 = 35% p = 0.99), or pre‐ to post‐ subsequent birth (OR = 0.79 95% CI 0.51–1.25; 13 studies, 5496 participants, I2 = 73% p = 0.31).ConclusionsDue to low evidence quality, we are unable to determine whether planned caesarean is protective against AI after OASI. Higher quality evidence is required to guide personalised decision‐making for asymptomatic women and to determine the effect of subsequent birth mode on long‐term AI outcomes.

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The long-term prevalence of anal incontinence in women with and without obstetric anal sphincter injuries

Cited by 2 publications

References 26 publications

Prevalence of pelvic floor dysfunction in recreational athletes: a cross-sectional survey

Prevalence of pelvic floor dysfunction in recreational athletes: a cross-sectional survey

Caesarean section and anal incontinence in women after obstetric anal sphincter injury: A systematic review and meta‐analysis

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