title: Anal incontinence: long-term alterations in the incidence and healthcare usage.
abstract: OBJECTIVE
  The aim of the study was to determine the alterations in the occurrence of incontinence and how subjects suffering from incontinence seek and receive healthcare services over a 10-year follow-up period.
  
  
  METHODS
  Postal questionnaires (Wexner Incontinence Score, Fecal Incontinence Quality of Life Scale, a questionnaire to investigate the management of fecal incontinence and the frequency of urinary incontinence) were sent to subjects who had reported anal incontinence in our population-based study in 2003. For each incontinent person (n = 155) from the 2003 series, we identified two control subjects (n = 310) who did not suffer from incontinence.
  
  
  RESULTS
  Of the initially incontinent, 47 (58%) had remained incontinent after a follow up of 10 years. Almost 80% of the incontinent subjects in 2012 were female. Of the 152 initially continent, 12 (7.9%) had developed symptoms, all of whom were females. Urinary incontinence was present in approximately 60% of incontinent subjects. The majority (57.8%) of the subjects still incontinent in 2012 felt that they needed help for the complaint, but only 30.9% had received any, and only 7.4% received any benefit. The most common treatment was medication. The subjective incontinence impaired the quality of life.
  
  
  CONCLUSIONS
  Incontinence is a chronic long-lasting disorder. The current management of anal incontinence is not satisfactory. The primary healthcare system should be more aware of the nature of this condition to find and offer treatment for the patients.
authors.affiliation: School of Medicine, University of Tampere , Tampere , Finland.
authors.forename: Kirsi
authors.initials: K
authors.lastname: Lehto
authors.forename: Katariina
authors.initials: K
authors.lastname: Ylönen
authors.forename: Marja
authors.initials: M
authors.lastname: Hyöty
authors.forename: Pekka
authors.initials: P
authors.lastname: Collin
authors.forename: Heini
authors.initials: H
authors.lastname: Huhtala
authors.forename: Petri
authors.initials: P
authors.lastname: Aitola
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002908:Chronic Disease; D005242:Fecal Incontinence / Q000453:epidemiology* / Q000628:therapy*; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires
keywords: anal incontinence; healthcare usage; incidence