Non-Oral Poster 31

Abstract

OBJECTIVES: Patients with urine incontinence often have fecal incontinence. Some therapies for urge urine incontinence (e.g. neuromodulation) are effective treatments for fecal incontinence. We sought to determine if specific types of urine incontinence were predictive of symptoms of fecal urgency or fecal incontinence. MATERIALS AND METHODS: After receiving IRB approval, patients presenting for care between September, 2007, and June, 2009, prospectively completed validated surveys on urine and bowel dysfunction. Pertinent demographic and historical information was also recorded. Type of incontinence was defined by patient responses to items on the PFDI. Responses of moderate or greater bother were considered to be positive responses. RESULTS: 1,203 patients completed our evaluation. Urge urine incontinence (UUI) was present in 460 patients (43%). Stress urine incontinence (SUI) was found in 463 patients (44%). 285/1,070 (27%) women had both urge and stress incontinence. 173 (16%) women reported bothersome fecal urgency. 144/1,082 (13%) had fecal incontinence. Of the women with UUI, 112/435 (26%) also reported fecal urgency. Of the women with SUI, 102/435 (23%) reported fecal urgency. The risk of having symptoms of fecal urgency was greater if the patient had UUI (OR 3.30, 95%CI 2.32–4.68, P < 0.001) compared with SUI (OR 2.28, 95%CI 1.63–3.20, P < 0.001). However, when both were evaluated together, UUI was more strongly associated with fecal urgency (OR 2.76, 1.89–4.03, P < 0.001) than was SUI (OR 1.61, 1.11–2.33, P = 0.012). Of the women with UUI, 84/434 (19%) had fecal incontinence. Of the women with SUI, 83/439 (19%) had symptoms of fecal incontinence. The risk of having fecal incontinence was greater if the patient had symptoms of UUI (OR 2.91, 1.97–4.30, P < 0.001) compared with SUI (OR 2.47, 1.70–3.61, P < 0.001). When both were evaluated together, UUI was more strongly associated with fecal incontinence (OR 2.38, 1.56–3.63, P < 0.001) than was SUI (OR 1.74, 1.15–2.63, P = 0.009). CONCLUSION: Patients with symptoms of urge urine incontinence are more likely to have symptoms of fecal urgency than those with stress urine incontinence. Patients with urge urine incontinence are also more likely to have fecal incontinence. There may be a common pathophysiology between urge urine incontinence and fecal incontinence symptoms.