title: Anal incontinence and vesico-sphincter events in systemic sclerosis: An epidemiologic bicentric cohort study.
abstract: To estimate the frequency and severity of anal incontinence and vesico-sphincter events, associated factors, and impact on the quality of life of patients with systemic sclerosis.
  
  
  
  Questionnaires assessing anal incontinence (Miller score), vesico-sphincter events (Urogenital Distress Inventory) and quality of life [Short Form Health Survey 36v2 (SF-36), and Hospital Anxiety and Depression Scale] were mailed to 139 patients with systemic sclerosis at the university hospitals of Besançon and Poitiers, France. Clinical data were collected from the medical records to identify risk factors.
  
  
  
  Among the 121 (87%) responders, severe vesico-sphincter events or severe anal incontinence occurred in 3.4% and 12.4% of cases, respectively. Frequent urination (66.3%) and anal incontinence to gas (50.4%) were the most frequent symptoms. Anal incontinence was associated positively with vesico-sphincter events, unrelated to obstetrical factors. No correlations were seen with age, sex, or systemic sclerosis characteristics. In multivariate analysis, moderate or severe vesico-sphincter events was associated with higher anxiety and depression scores and lower SF-36 scores; the same results were observed for anal incontinence, but did not reach significance.
  
  
  
  Vesico-sphincter events and anal incontinence are common in systemic sclerosis, and sometimes severe, with a potential negative impact in quality of life. These results will be confirmed by a case-control study with dynamic and manometric assessment, and could legitimate a systematic screening to ensure early therapy and multidisciplinary individual management.
authors.affiliation: Department of Internal Medicine, Besancon University Hospital, BESANCON Cédex, France. Electronic address: mickael.martin@chru-strasbourg.fr.
authors.forename: Mickaël
authors.initials: M
authors.lastname: Martin
authors.affiliation: Department of Internal Medicine, Besancon University Hospital, BESANCON Cédex, France.
authors.forename: Nadine
authors.initials: N
authors.lastname: Meaux-Ruault
authors.affiliation: Department of Internal Medicine, Besancon University Hospital, BESANCON Cédex, France.
authors.forename: Nadine
authors.initials: N
authors.lastname: Magy-Bertrand
authors.affiliation: Department of Internal Medicine, Infectious and Tropical Diseases, Poitiers University Hospital, Poitiers, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Beraud
authors.affiliation: Department of Physiotherapy and Rehabilitation, Besancon University Hospital, BESANCON Cédex, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Parratte
authors.affiliation: Department of Internal Medicine, Infectious and Tropical Diseases, Poitiers University Hospital, Poitiers, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Roblot
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005242:Fecal Incontinence / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D012595:Scleroderma, Systemic / Q000150:complications*; D012720:Severity of Illness Index
keywords: Fecal incontinence, Urinary bladder; Quality of life; Systemic sclerosis