title: Prevalence of anal incontinence in women with symptoms of urinary incontinence and genital prolapse.
abstract: OBJECTIVE
  To investigate risk factors and prevalence of anal incontinence among women with pelvic floor dysfunctions.
  
  
  METHODS
  We evaluated 881 women with symptoms of urinary incontinence and/or genital prolapse. Each completed a bowel questionnaire and underwent a detailed medical, surgical, obstetric, and gynecologic history, and a pelvic examination. Additional testing, when indicated, included office cystometry or multichannel urodynamic evaluation. Multivariable analysis using logistic regression was used to test the overall significance of all variables significantly associated with anal incontinence, using univariate analysis.
  
  
  RESULTS
  A total of 178 women had anal incontinence (20%). These patients were on average older, had a greater body mass index, and had larger birth weight infants than their anal-continent counterparts; 511 were diagnosed with urinary incontinence, and 122 (24%) also had anal incontinence. Women with urinary incontinence were more likely to report anal incontinence events than women continent of urine (24% versus 15%, P =.002). The following associations were found with anal incontinence: infant with birth weight 3800 g or greater (odds ratio [OR] 1.5, 95% confidence interval [CI] 1.1, 2.2), rectocele greater than grade 2 (OR 1.9, 95% CI 1.1, 3.3), urinary incontinence (OR 1.9, 95% CI 1.3, 2.8), hemorrhoidectomy (OR 2.7, 95% CI 1.1, 7.0), irritable bowel syndrome (OR 6.3, 95% CI 3.5, 11.5).
  
  
  CONCLUSIONS
  Among women with symptoms of urinary incontinence and pelvic organ prolapse, the prevalence of anal incontinence was 20%. Urinary incontinence and severe rectocele were found to be associated with anal incontinence.
authors.affiliation: Urogynecology Unit, Department of Obstetrics and Gynecology, University of Milan, Milan, Italy. m.meschia@libero.it
authors.forename: Michele
authors.initials: M
authors.lastname: Meschia
authors.forename: Arturo
authors.initials: A
authors.lastname: Buonaguidi
authors.forename: Paola
authors.initials: P
authors.lastname: Pifarotti
authors.forename: Edgardo
authors.initials: E
authors.lastname: Somigliana
authors.forename: Maurizio
authors.initials: M
authors.lastname: Spennacchio
authors.forename: Fabio
authors.initials: F
authors.lastname: Amicarelli
mesh_terms: D005242:Fecal Incontinence / Q000453:epidemiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D015995:Prevalence; D020047:Rectocele / Q000453:epidemiology; D012307:Risk Factors; D014549:Urinary Incontinence / Q000453:epidemiology*; D014596:Uterine Prolapse / Q000453:epidemiology*