Patterns of constipation in urogynecology: clinical importance and pathophysiologic insights.
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.
Soligo
Marco
M
Department of Gynecological Surgery, University of Milan-Bicocca-Bassini Hospital, Cinisello Balsamo (Milano), Italy. marcosoligo@fastwebnet.it
Salvatore
Stefano
S
Emmanuel
Anton V
AV
De Ponti
Elena
E
Zoccatelli
Marco
M
Cortese
Marina
M
Milani
Rodolfo
R
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