title: Prevalence of urinary and faecal incontinence among female members of the Hypermobility Syndrome Association (HMSA).
abstract: The benign joint hypermobility syndrome (BJHS) is a hereditary connective tissue disorder (formerly, EDS III) occurring due to abnormalities of collagen causing laxity of joint ligaments. In a cohort study by Jha et al. (2007), it was found that the prevalence of both urinary and faecal incontinence appears to be significantly higher in women with BJHS when compared with women without this condition. We aimed to confirm these findings among members of the Hypermobility Association, nationwide. A postal/e-mail questionnaire was sent to 373 members of the Hypermobility Syndrome Association (HMSA) who agreed to participate in this study. The basic demographic details including age, race, parity, body mass index (BMI), along with validated questionnaires such as International Consultation on Incontinence Questionnaire (ICIQ) and ICIQ-Bowel Symptoms (ICIQ-BS) were sent to the HMSA members.
  
  
  METHODS
  women with a proven hospital specialist diagnosis of BJHS. A total of 148 responses were analysed with a usable response rate of 40%. Overall prevalence of urinary incontinence in this group was 68.9%. The estimated prevalence of incontinence in a similar population without this condition was 30%. They have been classified by tactiles when analysed with ICIQ scores: Group 1=0 (n=46); Group 2=1-5 (n=36); Group 3=5-10 (n=33); Group 4=11-21 (n=33). Prevalence of faecal incontinence among members of HMSA is 14.9% (n=22). The prevalence of faecal incontinence in the general adult population by contrast is 2.2%. Increasing age and BMI affects the ICIQ scores significantly (p<0.05) among women with faecal incontinence. The prevalence of both urinary and faecal incontinence is significantly higher in women with BJHS when compared with women without this condition. Increasing BMI but not age is associated with the higher ICIQ scores with reference to urinary incontinence, whereas both increasing age and BMI increases the risk of faecal incontinence in this group of women.
authors.affiliation: Department of Urogynaecology, City Hospital, Birmingham, UK. anga.Arunkalaivanan@swbh.nhs.uk
authors.forename: A S
authors.initials: AS
authors.lastname: Arunkalaivanan
authors.forename: A
authors.initials: A
authors.lastname: Morrison
authors.forename: S
authors.initials: S
authors.lastname: Jha
authors.forename: A
authors.initials: A
authors.lastname: Blann
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004535:Ehlers-Danlos Syndrome / Q000150:complications*; D005242:Fecal Incontinence / Q000150:complications* / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D006801:Humans; D007593:Joint Instability / Q000150:complications*; D008875:Middle Aged; D011177:Postal Service; D015995:Prevalence; D012720:Severity of Illness Index; D006113:United Kingdom / Q000453:epidemiology; D014549:Urinary Incontinence / Q000150:complications* / Q000453:epidemiology