title: Clinical, urodynamic, and manometric findings in women with combined fecal and urinary incontinence.
abstract: OBJECTIVE
  To determine the prevalence of fecal incontinence in patients with urinary incontinence, who were referred for urodynamic evaluation, and to compare clinical and manometric findings between double incontinence and isolated fecal incontinence.
  
  
  METHODS
  Nine hundred women with urinary and/or fecal incontinence were prospectively investigated. Patients with double incontinence (group 1) were compared with 38 women with isolated fecal incontinence (group 2). Clinical data regarding obstetric and urogynecologic history, bowel habit, and type of fecal incontinence were collected. Urodynamics and anal manometry were performed.
  
  
  RESULTS
  Seventy-eight patients (8.7%) presented double incontinence. A history of vaginal delivery and chronic straining was more frequent in patients with double incontinence (P=0.043). No differences were found in the severity of fecal incontinence. Physical examination showed a greater prevalence of rectocele (54% vs. 12%) in group 1. On urodynamics, 80% of women with double incontinence had stress urinary incontinence. Rectal sensation testing revealed a significantly higher rate of hyposensitivity in group 2 (22% vs. 43%).
  
  
  CONCLUSIONS
  This study supports a close association between combined stress urinary and fecal incontinence, history of vaginal delivery, and chronic straining.
authors.affiliation: Digestive Motility Unit, Institut de Malalties Digestives, Hospital Clinic, Institut d' Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) University of Barcelona, Barcelona, Spain. glacima@medicina.ub.es
authors.forename: Gloria
authors.initials: G
authors.lastname: Lacima
authors.forename: Montserrat
authors.initials: M
authors.lastname: Espuña
authors.forename: Miguel
authors.initials: M
authors.lastname: Pera
authors.forename: Montserrat
authors.initials: M
authors.lastname: Puig-Clota
authors.forename: Llorenç
authors.initials: L
authors.lastname: Quintó
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: García-Valdecasas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005242:Fecal Incontinence / Q000150:complications / Q000503:physiopathology*; D005260:Female; D006801:Humans; D015994:Incidence; D008365:Manometry; D008875:Middle Aged; D011446:Prospective Studies; D012002:Rectal Diseases / Q000150:complications; D020047:Rectocele / Q000150:complications; D012678:Sensation Disorders / Q000150:complications; D014549:Urinary Incontinence / Q000150:complications / Q000503:physiopathology*; D014550:Urinary Incontinence, Stress / Q000150:complications / Q000453:epidemiology; D014563:Urodynamics