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Keywords:

  • fecal incontinence;
  • lower urinary tract symptoms;
  • pad test;
  • pelvic organ prolapse;
  • urodynamic stress incontinence

Abstract

Aim:  The aim of this study was to identify the factors associated with fecal incontinence in female patients with lower urinary tract symptoms.

Material and Methods:  Data regarding clinical and urodynamic parameters and history of fecal incontinence of 1334 women with lower urinary tract symptoms who had previously undergone urodynamic evaluation were collected and subjected to univariate, multivariate, and receiver–operator characteristic curve analysis to identify significant associations between these parameters and fecal incontinence.

Results:  Multivariate analysis identified age (odds ratio [OR] = 1.03, 95% confidence interval [CI] = 1.01–1.05, P = 0.005), presence of diabetes (OR = 2.10, 95%CI = 1.22–3.61, P = 0.007), presence of urodynamic stress incontinence (OR = 1.90, 95%CI = 1.24–2.91, P = 0.003), pad weight (OR = 1.01, 95%CI = 1.00–1.01, P = 0.04), and detrusor pressure at maximum flow (OR = 1.02, 95%CI = 1.01–1.03, P = 0.003) as independent risk factors for fecal incontinence. Receiver–operator characteristic curve analysis identified age ≥ 55 years, detrusor pressure at maximum flow ≥ 35 cmH2O, and pad weight ≥ 15 g as having positive predictive values of 11.4%, 11.5%, and 12.4%, respectively, thus indicating that they are the most predictive values in concomitant fecal incontinence.

Conclusions:  Detrusor pressure at maximum flow and pad weight may be associated with fecal incontinence in female patients with lower urinary tract symptoms, but require confirmation as indicators by further study before their use as screening tools.