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Urinary Symptoms and Bladder Voiding Dysfunction Are Common in Young Men with Defecatory Disorders: A Retrospective Evaluation

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Abstract

Background and Aims

Lower urinary tract symptoms (LUTS) are frequently reported by constipated patients. Prospective studies investigating the association between defecatory disorders (DDs) and voiding dysfunction, predominantly in women, have reported conflicting results. This study investigated (1) the prevalence of LUTS in young men with DDs and (2) the association between objectively documented DDs and voiding dysfunction in constipated young men with LUTS.

Methods

We reviewed the medical records, including validated questionnaires, of men aged 18–40 with confirmed DDs treated with pelvic floor physical therapy (PT) at our institution from May 2018 to November 2020. In a separate group of constipated young men with LUTS who underwent high-resolution anorectal manometry (HRM), rectal balloon expulsion test (BET), and uroflowmetry, we explored the relationship between DDs and voiding dysfunction.

Results

A total of 72 men were evaluated in the study. Among 43 men receiving PT for a proven DD, 82% reported ≥ 1 LUTS, most commonly frequent urination. Over half of these men experienced a reduction in LUTS severity after bowel-directed pelvic floor PT. Among 29 constipated men with LUTS who had undergone HRM/BET and uroflowmetry, 28% had concurrent defecatory and voiding dysfunction, 10% had DD alone, 14% had only voiding dysfunction, and 48% had neither. The presence of DD was associated with significantly increased odds of concurrent voiding dysfunction (odds ratio 9.3 [95% CI 1.7–52.7]).

Conclusions

Most young men with DDs experience LUTS, which may respond to bowel-directed physical therapy. Patients with DD and urinary symptoms have increased odds of voiding dysfunction.

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Abbreviations

BET:

Balloon expulsion test

CRADI-8:

Colorectal-Anal Distress Inventory 8

DD:

Defecatory disorder

HRM:

High-resolution anorectal manometry

IQR:

Interquartile range

LUTS:

Lower urinary tract symptoms

OR:

Odds ratio

PFIQ-7:

Pelvic Floor Impact Questionnaire

PVR:

Post-void residual

Qmax:

Maximum urine flow rate

STROBE:

Strengthening the reporting of observational studies in epidemiology

UDI-6:

Urinary Distress Inventory, Short Form

UIQ-7:

Urinary Impact Questionnaire

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Authors and Affiliations

  1. Department of Internal Medicine (Dr. White), Department of Urology (Dr. Linder), and Division of Gastroenterology and Hepatology (Drs. Szarka and Prichard), Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA

    Bradley A. White MD, Brian J. Linder MD, Lawrence A. Szarka MD & David O. Prichard MB, BCh, PhD

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  1. Bradley A. White MD
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  2. Brian J. Linder MD
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  3. Lawrence A. Szarka MD
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  4. David O. Prichard MB, BCh, PhD
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Contributions

BA White: Data curation, formal analysis, and writing (original draft). BJ Linder: Conceptualization, methodology, and writing (review & editing). LA Szarka: Conceptualization, methodology, and writing (review & editing). DO Prichard: Conceptualization, formal analysis, methodology, supervision, and writing (original draft, review & editing).

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Correspondence to David O. Prichard MB, BCh, PhD.

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White, B.A., Linder, B.J., Szarka, L.A. et al. Urinary Symptoms and Bladder Voiding Dysfunction Are Common in Young Men with Defecatory Disorders: A Retrospective Evaluation. Dig Dis Sci 67, 3036–3044 (2022). https://doi.org/10.1007/s10620-021-07167-z

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  • DOI: https://doi.org/10.1007/s10620-021-07167-z

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