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Defecatory dysfunction and anal incontinence symptoms among women with pelvic organ prolapse: 5-year retrospective study in a tertiary center

  • Urogynecology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objective

To investigate the prevalence of DD and AI with POP symptoms in females attending a urogynecology clinic, and to identify factors associated with DD and AI in POP symptoms patients.

Methods

Computer-based medical records of women with POP symptoms attending a urogynecology clinic in a referral tertiary center between January 2016 and December 2020 were reviewed. Demographic data were collected. Selected defecatory dysfunction (DD) and anal incontinence (AI) were recorded. The associations between patient characteristics, site and severity of prolapse, and DD and AI symptoms in POP patients were investigated for identified associated factors.

Results

The mean age of the 754 participants was 65.77 ± 9.44 years. Seven hundred and fifteen (94.83%) were menopause. The prevalence of DD and AI in patients with POP symptoms was 44.03% (332/754) and 42.04% (317/754) according to the PFBQ and medical history records, respectively. Advanced posterior wall prolapse (OR 1.59, 95% CI 1.10–2.30) and wider GH (OR1.23, 95% CI 1.05–1.43) were identified as risk factors for DD by multivariate analysis. Additionally, single-compartment prolapse (OR 0.4, 95% CI 0.21–0.76) and a stronger pelvic floor muscle assessed with brink score (OR 0.94, 95% CI 0.88–0.98) are protective factors for AI.

Conclusion

DD and AI are prevalent among women with POP symptoms who visit a urogynecology clinic. DD should be evaluated in women with POP symptoms especially in women with increased genital hiatus and point Ap beyond the hymen. To prevent AI, women with POP should be encouraged to perform pelvic floor muscle training in order to increase pelvic floor muscle strength.

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Data availability

The data that support the findings of this study are available from the corresponding authors upon reasonable request.

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Acknowledgements

The authors would like to thank Ms. Sasiporn Sitthisorn for assistance with the statistical analyses. The authors also thank Alison Sherwin, PhD, from Edanz (https://www.edanz.com/ac) for editing a draft of this manuscript. We would like to thank Dr.Kotchakorn Dulyapach for illustrating figure 2.

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Authors and Affiliations

  1. Department of Obstetrics & Gynaecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, 10400, Thailand

    Apisith Saraluck, Komkrit Aimjirakul, Ng Jun Jiet, Orawee Chinthakanan, Peeranuch Mangmeesri & Jittima Manonai

  2. Department of Obstetrics and Gynaecology, Kuala Lumpur Hospital, Jalan Pahang, 50586, Kuala Lumpur, Malaysia

    Ng Jun Jiet

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  1. Apisith Saraluck
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Contributions

Concept/idea/research design: A. Saraluck, K. Aimjirakul, J.J. Ng, J. Manonai. Data collection: A. Saraluck, P. Mangmeesri. Data analysis: A. Saraluck, O. Chinthakanan, J.J. Ng. Project management: J. Manonai. Manuscript writing: A. Saraluck, J. Manonai. All authors edited and approved the final version to be published.

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Correspondence to Apisith Saraluck or Jittima Manonai.

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The authors declare no conflicts of interest.

Ethical approval

This study was approved by the Medical and Research Ethics Committee of Ramathibodi Hospital Number MURA2022/750 (Expedited). Since this project was a retrospective chart review in which the data already exist, the informed consent was not required.

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Saraluck, A., Aimjirakul, K., Jiet, N.J. et al. Defecatory dysfunction and anal incontinence symptoms among women with pelvic organ prolapse: 5-year retrospective study in a tertiary center. Arch Gynecol Obstet 309, 2237–2245 (2024). https://doi.org/10.1007/s00404-024-07426-0

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