title: Faecal incontinence in men referred for specialty care: a cross-sectional study.
abstract: OBJECTIVE
  Little is known about men with faecal incontinence. We compared clinical findings and quality of life in a large cohort of men and women with faecal incontinence to guide its evaluation and treatment in men.
  
  
  METHODS
  We analysed men and women presenting to a tertiary referral centre with faecal incontinence between 2005 and 2013. Demographics, physical examination, anorectal physiology testing, symptom severity (Fecal Incontinence Severity Index) and quality of life (Fecal Incontinence Quality of Life Scale) were recorded. We determined differences between men and women and analysed the association between gender and quality of life.
  
  
  RESULTS
  Data were obtained from 144 men and 897 women. Men with faecal incontinence were slightly younger than women (55.3 vs 57.6 years, P = 0.001), more likely to report coexisting constipation (P = 0.004) and more likely to have normal internal and external sphincter function on physical examination (both P < 0.001). Anorectal physiology testing revealed fewer sphincter defects (P < 0.05) and less pudendal neuropathy (P < 0.05) in men compared with women. Although symptom severity and overall quality of life were similar, men had improved coping and less embarrassment compared with women after we adjusted for important clinical factors.
  
  
  CONCLUSIONS
  Men with faecal incontinence presenting to a tertiary referral centre are more likely than women to have a mixed presentation characterized by constipation and less sphincter dysfunction. They exhibited better coping and less embarrassment than women. These findings should be taken into consideration when evaluating and treating men with faecal incontinence.
authors.affiliation: Philip R. Lee Institute for Health Policy Studies and Department of Surgery, University of California, San Francisco, California, USA.
authors.forename: J N
authors.identifier: http://orcid.org/0000-0002-5461-4716
authors.initials: JN
authors.lastname: Cohan
authors.affiliation: Department of Surgery, University of California, San Francisco, California, USA.
authors.forename: A B
authors.initials: AB
authors.lastname: Chou
authors.affiliation: Section of Colorectal Surgery, Department of Surgery, University of California, San Francisco, California, USA.
authors.forename: M G
authors.initials: MG
authors.lastname: Varma
mesh_terms: D000223:Adaptation, Psychological; D001003:Anal Canal / Q000503:physiopathology*; D003248:Constipation / Q000150:complications; D003430:Cross-Sectional Studies; D005242:Fecal Incontinence / Q000150:complications / Q000503:physiopathology* / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D060525:Pudendal Nerve / Q000503:physiopathology; D011788:Quality of Life; D012007:Rectum / Q000503:physiopathology*; D012017:Referral and Consultation; D012677:Sensation; D012720:Severity of Illness Index; D012737:Sex Factors; D012752:Shame; D062606:Tertiary Care Centers
keywords: Fecal incontinence; anorectal manometry; gender; quality of life