FECAL INCONTINENCE IN WOMEN WITH URINARY-INCONTINENCE AND PELVIC ORGAN PROLAPSE

Objective: To determine the prevalence of and factors associated with fecal incontinence in women with urinary incontinence or pelvic organ prolapse. Methods: Study subjects were recruited prospectively, and al l participants received questionnaires regarding bowel function and un derwent a standardized history and physical examination. Fecal inconti nence was defined as the involuntary loss of feces sufficient to be co nsidered a problem by the patient. Results: Forty-two subjects had fec al incontinence, an overall prevalence of 17%. One hundred seventy wom en had urinary incontinence, pelvic organ prolapse, or both, and 36 of these (21%) had fecal incontinence. One hundred (40%) women had urina ry incontinence, of whom 31 also had fecal incontinence. Seventy women had isolated pelvic organ prolapse and Eve (7%) were incontinent of f eces. Univariate analysis revealed that any degree of pelvic organ pro lapse, increasing degrees of prolapse within each vaginal segment, uri nary incontinence, advanced age, postmenopausal status, increased vagi nal parity, prior hysterectomy, history of irritable bowel syndrome, a nd abnormal sphincter tone were associated significantly with fecal in continence. Multiple logistic regression analysis indicated that only urinary incontinence (odds ratio [OR] 4.6, P < .001, 95% confidence in terval [CI] 1.9, 11.2), abnormal anal sphincter tone (OR 2.3, P = .04, 95% CI 1.1, 5.1), and irritable bowel syndrome (OR 8.3, P = .002, 95% CI 2.1, 32.8) were associated with fecal incontinence. Conclusions: T here is a high rate of fecal incontinence in women with urinary incont inence and pelvic organ prolapse. Clinicians providing health care to a similar group of women should inquire routinely and specifically abo ut fecal incontinence. Copyright (C) 1997 by The American College of O bstetricians and Gynecologists.