Quality of Life Differences in Female and Male Patients with Fecal Incontinence.
OBJECTIVE
To explore and compare quality of life (QoL) differences in female and male patients with fecal incontinence.


METHODS
Ninety-one patients with fecal incontinence (60 women, mean (SD) age 64.13 (9.72) years; 31 men, mean (SD) age 63.61 (13.33) years) were assessed for pathophysiology (anorectal manometry and ultrasound), clinical severity (Wexner and Vaizey scales), QoL (Fecal Incontinence Quality of Life Score [FIQL]) and health status (EQ-5D).


RESULTS
External and internal anal sphincter impairment rates were 96.5% and 70.2%, respectively, in women, compared to 30% and 43.3% respectively in men (P< 0.05). Clinical severity was similar in both sexes, with mean (SD) Wexner scores of 10.95 (4.35) for women and 9.81 (4.30) for men, and mean (SD) Vaizey scores of 13.27 (4.66) for women and 11.90 (5.22) for men. Scores for women were significantly lower for all FIQL depression and coping subscales (P< 0.001) and the EQ-5D depression subscale (P< 0.01). EQ-5D index was 0.687 (0.20) for women and 0.835 (0.15) for men (P< 0.001). QoL was negatively affected by female gender (?1.336), anxiety/depression (?1.324) and clinical severity (?0.302), whereas age had a positive impact (0.055 per year) (P< 0.01).


CONCLUSIONS
The pathophysiology of fecal incontinence differed between the sexes. For similar severity scores, impact on QoL was higher in women. Gender had the highest impact on QoL compared to other factors. QoL measurements should be part of assessment and treatment protocols.
Unitat d'Exploracions Funcionals Digestives, Department of Surgery, Hospital de Mataró, Universitat Autònoma de Barcelona, Mataró, Spain.|Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain.
Lluís
L
Mundet
Department of Surgery, Consorci Sanitari de Terrassa, Terrassa, Spain.
Yolanda
Y
Ribas
Department of Nursing, Badalona Serveis Assistencials, Badalona, Spain.|Escola Superior de Ciències de la Salut, Tecnocampus, Mataró, Spain.
Sandra
S
Arco
Unitat d'Exploracions Funcionals Digestives, Department of Surgery, Hospital de Mataró, Universitat Autònoma de Barcelona, Mataró, Spain.|Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain.|Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III, Barcelona, Spain.
Pere
P
Clavé
Fecal incontinence; Pathophysiology; Quality of life; Sex