Patterns of constipation in urogynecology: clinical importance and pathophysiologic insights

Am J Obstet Gynecol. 2006 Jul;195(1):50-5. doi: 10.1016/j.ajog.2005.12.046. Epub 2006 Apr 21.

Abstract

Objective: We have analyzed the prevalence and patterns of constipation in women with urinary symptoms and/or genital prolapse.

Study design: Seven hundred and eighty-six consecutive urogynecologic patients underwent a questionnaire and structured clinical assessment. Comparison between constipated and nonconstipated women was made. Fisher exact test, Wilcoxon rank sum test, and logistic regression were used for statistical analysis (P < .05 for significance).

Results: Thirty-two percent of women were constipated (172 difficult stool passage, 13 reduced stool frequency, 64 both). A genital prolapse > or = 2 degree Half Way System (HWS) was present in 44% of women. A posterior colpocele was more frequent in constipated women (35% vs 19%; P < .0001), resulting in a risk factor for constipation (OR 2.31; 95% CI 1.63-3.27). By contrast, higher degrees of anterior colpocele appeared to protect against constipation (OR 0.80; 95% CI 0.66-0.96). No differences in prevalence of constipation were observed for urinary symptoms or urodynamic diagnosis.

Conclusion: Bowel dysfunction correlates exclusively with posterior aspects of the pelvic floor support.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Comorbidity
  • Constipation / epidemiology*
  • Fecal Incontinence / epidemiology
  • Female
  • Humans
  • Logistic Models
  • Middle Aged
  • Prevalence
  • Retrospective Studies
  • Urinary Incontinence / epidemiology
  • Urination Disorders / epidemiology*
  • Urodynamics
  • Uterine Prolapse