Prevalence of unreported bowel symptoms in women with pelvic floor dysfunction and the impact on their quality of life

Abstract

Little information is available on the recurrent coexistence of pelvic organ prolapse (POP), urinary (UI) and/or anal (AI) incontinence and defecatory dysfunctions and the relationship between these disorders. The purpose of this study is to report the prevalence, bother, and impact on quality of life (QoL) of unreported bowel symptoms in women presenting to a Brazilian tertiary urogynecology clinic. The study was a cross-section survey of 172 patients with symptoms of pelvic floor disorders (PFD). Patients who reported any defecatory and/or continence disorders were included in the study group, and the others were included in the control group. Patients with UI were also compared with those with double incontinence (DI): AI and UI. Univariate analysis was conducted using the Mann-Whitney U test for continuous nonparametric data. After the interview, 54.6% (n = 94) of patients presented AI and/or defecatory disorders: 67.0% constipation, 41.4% AI, and 34.0% fecal urgency. Women from the study group scored worse in the QoL questionnaires compared with women from the control group. Among women with UI, 23.21% had associated AI. Women with DI scored worse in the QoL questionnaires. Anal and urinary dysfunctions are usually associated and have a great impact on a woman's QoL. An integrated approach across specialties should lead to improved patient care. Therefore, our study is relevant because it emphasizes the importance of urogynecologists routinely investigating such symptoms. To do so, standardized questionnaires should be included in the evaluation of all these patients.