title: Symptom improvement in women after fecal incontinence treatments: a multicenter cohort study of the pelvic floor disorders network.
abstract: OBJECTIVE
  The study aims were to characterize women with fecal incontinence (FI) and measure changes in FI severity and quality of life 3 and 12 months after treatment.
  
  
  METHODS
  This study is a secondary analysis of a multicenter study measuring adaptive behaviors among women with FI. Women included had a primary complaint of at least monthly FI over 3 consecutive months and planned FI treatment. Demographic and medical history data were obtained at baseline. Data were collected at baseline, 3 months, and 12 months after clinically selected, nonstandardized treatment. Validated questionnaires were as follows: Fecal Incontinence Severity Index, Modified Manchester Health Questionnaire, Pelvic Floor Disorders Inventory's Colorectal and Anal Distress Inventory, Pelvic Floor Impact Questionnaire's Colorectal and Anal Impact Questionnaire, and Medical Outcomes Study Short Form. Questionnaire score changes from baseline were compared using paired t tests at 3 and 12 months after treatment.
  
  
  RESULTS
  Of the 133 women enrolled, 90 women had treatment data at 3 months and 77 at 12 months. Nonsurgical therapies were the most common (78%) with anal sphincter repair in 22%. Fecal Incontinence Severity Index scores and Modified Manchester Health Questionnaire scores significantly improved 3 months after nonsurgical and surgical treatments (-8.8 ± 12.0 and -12.6 ± 19.2, respectively, P < 0.001), as did Colorectal-Anal Distress Inventory and Colorectal-Anal Impact Questionnaire scores (-52.7 ± 70.0 and -60.6 ± 70.0, respectively, P < 0.001) and Medical Outcomes Study Short Form mental health scores (4.2 ± 9.4, P = 0.001). Improvement persisted 12 months posttreatment.
  
  
  CONCLUSIONS
  In women seeking care for FI, symptom severity and condition-specific quality of life significantly improve within the first 3 months after FI treatment and are maintained up to 12 months.
authors.affiliation: From the *Birmingham Veterans Affairs Medical Center, University of Alabama at Birmingham, Birmingham, AL; †Department of Biostatistics, University of Michigan, Ann Arbor, MI; ‡Department of Obstetrics, Gynecology, and Women's Health Institute, Cleveland Clinic, Cleveland, OH; §Department of Obstetrics and Gynecology, Stritch School of Medicine, Loyola University Chicago, Chicago, IL; ∥Department of Medicine, Salt Lake City Veterans Affairs Medical Center, University of Utah, Salt Lake City, UT; ¶Department of Obstetrics and Gynecology, Duke University, Durham, NC; #Department of Medicine, Stritch School of Medicine, Loyola University Chicago, Chicago, IL; **Department of Obstetrics and Gynecology, University of Texas Southwestern, Dallas, TX; ††The Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD; and ‡‡Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL.
authors.forename: Alayne
authors.initials: A
authors.lastname: Markland
authors.forename: Lu
authors.initials: L
authors.lastname: Wang
authors.forename: J Eric
authors.initials: JE
authors.lastname: Jelovsek
authors.forename: Linda
authors.initials: L
authors.lastname: Brubaker
authors.forename: Ashook
authors.initials: A
authors.lastname: Tuteja
authors.forename: Alison C
authors.initials: AC
authors.lastname: Weidner
authors.forename: Andelka
authors.initials: A
authors.lastname: LoSavio
authors.forename: Marlene
authors.initials: M
authors.lastname: Corton
authors.forename: Susan
authors.initials: S
authors.lastname: Meikle
authors.forename: Holly E
authors.initials: HE
authors.lastname: Richter
mesh_terms: D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000601:surgery; D004043:Dietary Fiber / Q000008:administration & dosage; D005081:Exercise Therapy; D005242:Fecal Incontinence / Q000523:psychology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D017773:Pelvic Floor; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors