Pelvic floor dysfunction after Burch colposuspension--a comprehensive study. Part II.
OBJECTIVE
To evaluate the prevalence of pelvic floor dysfunction (PFD) concerning bowel function at long-term follow-up after Burch colposuspension (Bc) in relation to the bowel function in an age-matched sample of women in the general population.


METHODS
This is a follow-up study of a cohort of 190 patients who underwent Bc in 1980-1988 and 305 age-matched control women without urinary anti-incontinence surgery, randomly selected from the general population. The participants answered a postal questionnaire with detailed questions about the pelvic floor function in 1998. Univariate and multivariate analyses were performed.


RESULTS
The patients showed considerable signs of bowel dysfunction compared with the general population in the following aspects: they used the fingers to help emptying the bowel [odds ratio (OR) 3.25 (1.35-7.86)]; had feeling of incomplete emptying of the bowel [OR 2.29 (1.11-4.73)]; felt no warning before passing a motion [OR 3.04 (1.20-7.71)]; had gas incontinence [OR 1.98 (1.17-3.37); had loose stool incontinence [OR 3.67 (1.43-9.42)]; used protection against fecal leakage during daytime [OR 3.22 (1.30-7.95)]; and experienced that the bowel function affected the general well-being adversely [OR 2.15 (1.30-3.56)].


CONCLUSIONS
The patients who have undergone colposuspension for stress urinary incontinence have more symptoms of PFD concerning the bowel function than women without urinary anti-incontinence surgery in the general population. This affects the general well-being. A comprehensive concept of multidisciplinary assessment and treatment of PFD should be encouraged.
Kjølhede
Preben
P
Division of Obstetrics and Gynecology, Faculty of Health Sciences, University Hospital, 581-85 Linköping, Sweden. preben.kjolhede@lio.se
Wahlström
Johan
J
Wingren
Gun
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003127:Colposcopy / Q000009:adverse effects* / Q000379:methods; D003248:Constipation / Q000209:etiology* / Q000503:physiopathology; D005242:Fecal Incontinence / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D005414:Flatulence / Q000209:etiology* / Q000503:physiopathology; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D017773:Pelvic Floor / Q000503:physiopathology*; D013526:Surgical Mesh; D011795:Surveys and Questionnaires; D014550:Urinary Incontinence, Stress / Q000601:surgery*