title: Prevalence of double incontinence, risks and influence on quality of life in a general female population.
abstract: BACKGROUND
  Urinary incontinence (UI) and anal incontinence (AI) are complaints with impact on quality of life (QOL). Few data are available on prevalence of double incontinence (DI) in the general female population.
  
  
  OBJECTIVE
  To determine prevalence of UI, AI, and DI, their associations with age, parity, and effects on QOL.
  
  
  METHODS
  Cross-sectional study on a general female population, aged 45-85 years.
  
  
  METHODS
  Validated questionnaires measuring pelvic floor dysfunction and QOL. A short questionnaire was used for non-responders. Analyses were performed with Chi-square tests, ANOVA, and logistic regression.
  
  
  RESULTS
  Response rate was 62.7% (1,869/2,979); 59% of non-responders filled in the short questionnaire (620/1,051). No significant differences in stress urinary incontinence, vaginal bulging, solid stool incontinence and parity were found between responders and non-responders. DI with and without flatal incontinence were reported by 7.7% and 35.4%, respectively. Women with urge urinary incontinence (UUI) alone had an OR of 4.3 (95% CI 2.4-7.9) for liquid stool incontinence, 1.6 (95% CI 0.5-4.9) for solid stool incontinence and 2.4 for flatal incontinence (95% CI 1.5-3.8). Women with AI had an OR of 5.8 (95% CI 1.8-18.2) for UUI. Women with DI including flatus reported significantly poorer QOL. Limitation of the study was the lack of objective clinical validation of symptoms, which may have influenced the real prevalence data.
  
  
  CONCLUSIONS
  Most important relation was found between UUI and liquid stool incontinence (OR 4.3). We recommend that clinicians take the history of patients with UUI or mixed urinary incontinence to exclude the co-existence of AI.
authors.affiliation: Department of Obstetrics and Gynaecology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands. m.slieker@somt.nl
authors.forename: Marijke C Ph
authors.initials: MC
authors.lastname: Slieker-ten Hove
authors.forename: Annelies L
authors.initials: AL
authors.lastname: Pool-Goudzwaard
authors.forename: Marinus J C
authors.initials: MJ
authors.lastname: Eijkemans
authors.forename: Regine P M
authors.initials: RP
authors.lastname: Steegers-Theunissen
authors.forename: Curt W
authors.initials: CW
authors.lastname: Burger
authors.forename: Mark E
authors.initials: ME
authors.lastname: Vierhout
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005242:Fecal Incontinence / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D017773:Pelvic Floor / Q000503:physiopathology; D044382:Population Groups; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D011795:Surveys and Questionnaires / Q000592:standards; D014549:Urinary Incontinence / Q000175:diagnosis / Q000453:epidemiology*; D014550:Urinary Incontinence, Stress / Q000453:epidemiology