title: Patterns of constipation in urogynecology: clinical importance and pathophysiologic insights.
abstract: OBJECTIVE
  We have analyzed the prevalence and patterns of constipation in women with urinary symptoms and/or genital prolapse.
  
  
  METHODS
  Seven hundred and eighty-six consecutive urogynecologic patients underwent a questionnaire and structured clinical assessment. Comparison between constipated and nonconstipated women was made. Fisher exact test, Wilcoxon rank sum test, and logistic regression were used for statistical analysis (P < .05 for significance).
  
  
  RESULTS
  Thirty-two percent of women were constipated (172 difficult stool passage, 13 reduced stool frequency, 64 both). A genital prolapse > or = 2 degree Half Way System (HWS) was present in 44% of women. A posterior colpocele was more frequent in constipated women (35% vs 19%; P < .0001), resulting in a risk factor for constipation (OR 2.31; 95% CI 1.63-3.27). By contrast, higher degrees of anterior colpocele appeared to protect against constipation (OR 0.80; 95% CI 0.66-0.96). No differences in prevalence of constipation were observed for urinary symptoms or urodynamic diagnosis.
  
  
  CONCLUSIONS
  Bowel dysfunction correlates exclusively with posterior aspects of the pelvic floor support.
authors.affiliation: Department of Gynecological Surgery, University of Milan-Bicocca-Bassini Hospital, Cinisello Balsamo (Milano), Italy. marcosoligo@fastwebnet.it
authors.forename: Marco
authors.initials: M
authors.lastname: Soligo
authors.forename: Stefano
authors.initials: S
authors.lastname: Salvatore
authors.forename: Anton V
authors.initials: AV
authors.lastname: Emmanuel
authors.forename: Elena
authors.initials: E
authors.lastname: De Ponti
authors.forename: Marco
authors.initials: M
authors.lastname: Zoccatelli
authors.forename: Marina
authors.initials: M
authors.lastname: Cortese
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Milani
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003248:Constipation / Q000453:epidemiology*; D005242:Fecal Incontinence / Q000453:epidemiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D014549:Urinary Incontinence / Q000453:epidemiology; D014555:Urination Disorders / Q000453:epidemiology*; D014563:Urodynamics; D014596:Uterine Prolapse