Posterior vaginal prolapse and bowel function

OBJECTIVE: This study's objectives were to describe symptoms related to bow el dysfunction in women with uterovaginal prolapse and to compare these sym ptoms according to extent of posterior vaginal prolapse. STUDY DESIGN: One hundred forty-three women completed a questionnaire asses sment of bowel function and underwent standardized physical examination acc ording to the International Continence Society's system for grading uterova ginal prolapse. RESULTS: The mean age was 59.2 years (SD 11.8 years); 78% of the women were postmenopausal. According to the furthest extent of posterior vaginal prol apse at point Bp, 22 (15.5%) were in stage 0, 46 (32.4%) were in stage 1, 5 0 (35.2%) were in stage 11, 23 (16.2%) were in stage III, and 1 (0.7%) was in stage IV. Ninety-two percent of women reported having bowel movements at least every other day. When asked whether straining was required for them to have a bowel movement, 38 (26.6%) reported never or rarely, 71 (49.6%) r eported sometimes, 20 (14.0%) reported usually, and 14(9.8%) reported alway s. When asked whether they ever needed to help stool come out by pushing wi th a finger in the vagina or rectum, 98 (69.0%) reported never or rarely, 3 0 (21.1%) reported sometimes, 8 (5.6%) reported usually and 6 (4.2%) report ed always. Twenty-three women (16.1%) had fecal incontinence, with 11 havin g loss of control of stool less often than once a month and 12 having it mo re often than once a month. When asked whether to rate how much they were b othered by their bowel function on a scale of 1 to 10, with I being not at all and 10 being extremely, 51.7% of women chose 1 to 4, 20.3% chose 5 to 7 , and 28% chose greater than or equal to 8. There were no clinically signif icant associations between any of the questions related to bowel function a nd severity of posterior vaginal prolapse. CONCLUSION: Women with uterovaginal prolapse frequently have symptoms relat ed to bowel dysfunction, but this is not associated with the severity of po sterior vaginal prolapse.