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Patterns of constipation in urogynecology: clinical importance and pathophysiologic insights.

Soligo M, Salvatore S, Emmanuel AV, De Ponti E, Zoccatelli M, Cortese M, Milani R

Department of Gynecological Surgery, University of Milan-Bicocca-Bassini Hospital, Cinisello Balsamo (Milano), Italy. marcosoligo@fastwebnet.it

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.

Published 3 July 2006 in Am J Obstet Gynecol, 195(1): 50-5.
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