Advertisement

International Urogynecology Journal

, Volume 23, Issue 12, pp 1785–1789 | Cite as

Lower urinary tract symptoms in chronically constipated women

  • Dan CarterEmail author
  • Marc Beer-Gabel
Original Article

Abstract

Introduction and hypothesis

The prevalence of lower urinary tract symptoms (LUTS) is as high as 66 % in the general population. Constipation rates of >30 % were reported among women with LUTS. We examined the association of chronic constipation to the occurrence of LUTS and, in particular, the relationship of LUTS to the type of constipation. We also examined the prevalence and association of pelvic organ prolapse (POP) to LUTS.

Methods

In a retrospective survey of data collected on patients referred to our clinic during 2008–2009 for assessment of chronic constipation, 161 constipated women and 162 healthy female volunteers completed a structured questionnaire of urinary and bowel habits components (BBUS-Q22), the constipation scoring system for assessment of constipation severity and the Rome III component for IBS and chronic constipation. The constipated group underwent dynamic transperineal ultrasound.

Results

Demographic data was similar in both groups. LUTS were more common in the constipated group (increased urinary frequency 34 % vs. 14 %, p < 0.001, nocturia 31 % vs. 8 %, p < 0.001, urinary urgency 53 % vs. 21 %, p < 0.001, incomplete urinary emptying 24 % vs. 9 %, p = 0.003 and urinary incontinence 21 % vs. 5 %, p < 0.0001). Urinary symptoms did not vary between IBS and functional constipation. In addition, the occurrence of urinary symptoms was unrelated to the diagnosis of posterior pelvic organ prolapse (POP) in the constipated group.

Conclusions

LUTS are common in constipated women, but are unrelated to the type of constipation. These findings may suggest that the constipation process may have a direct contribution to the occurrence of LUTS.

Keywords

Constipation LUTS POP IBS 

Notes

Conflicts of interest

None.

References

  1. 1.
    Chang L, Toner BB, Fukudo S et al (2006) Gender, age, society, culture, and the patients perspective in functional gastrointestinal disorders. Gastroenterology 130:1434–1446Google Scholar
  2. 2.
    Higgins PD, Johnson JF (2004) Epidemiology of constipation in north America. A systemic review. Am J Gastroenterol 99:750–759PubMedCrossRefGoogle Scholar
  3. 3.
    Stewart WF, Liberman JN, Sandler RS et al (1999) Epidemiology of constipation (EPOC) study in the United States: relation of clinical subtypes to sociodemographic features. Am J Gastroenterol 94:3530–3540PubMedCrossRefGoogle Scholar
  4. 4.
    Vrama MG, Hart LH, Brown SB et al (2008) Obstructive defecation in idle ages women. Dig Dis Sci 53:2702–2709CrossRefGoogle Scholar
  5. 5.
    Drossman DA, Corrazziari E, Delvaux M et al (2006) Rome III. The functional gastrointestinal disorders. Degnon associates. Mclean, VirgeniaGoogle Scholar
  6. 6.
    Møller LA, Lose G, Jørgensen T (2000) The prevalence and bothersomeness of lower urinary tract symptoms in women 40–60 years of age. Acta Obstet Gynecol Scand 79(4):298–305PubMedCrossRefGoogle Scholar
  7. 7.
    Boyle P, Robertson C, Mazzetta C, Keech M, Hobbs FD, Fourcade R et al (2003) The prevalence of lower urinary tract symptoms in men and women in four centers. The UrEpik study. BJU Int 92(4):409–414PubMedCrossRefGoogle Scholar
  8. 8.
    Irwin DE, Milsom I, Hunskaar S et al (2006) Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study. Eur Urol 50:1306–1314PubMedCrossRefGoogle Scholar
  9. 9.
    Irwin DE, Milsom I, Kopp Z, Abrams P, Artibani W, Herschorn S (2009) Prevalence, severity, and symptom bother of lower urinary tract symptoms among men in the EPIC study: impact of overactive bladder. Eur Urol 56:14–20PubMedCrossRefGoogle Scholar
  10. 10.
    Chapple CR, Wein AJ, Abrams P et al (2008) Lower urinary tract symptoms revisited: a broader clinical perspective. Eur Urol 54(3):563–569PubMedCrossRefGoogle Scholar
  11. 11.
    Abrams P, Cardozo L, Fall M et al (2002) The standardization of terminology of lower urinary tract function: report from the Standardization Sub-committee of the International Continence Society. Neurourol Urodyn 21:167–178PubMedCrossRefGoogle Scholar
  12. 12.
    Ng SC, Chen YC, Lin LY, Chen GD (2002) Anorectal dysfunction in women with urinary incontinence or lower urinary tract symptoms. Int J Gynaecol Obstet 77:139–145PubMedCrossRefGoogle Scholar
  13. 13.
    Soligo M, Salvatore S, Emmanuel AV et al (2006) Patterns of constipation in urogynecology: clinical importance and pathophysiologic insights. Am J Obstet Gynecol 195:108–116CrossRefGoogle Scholar
  14. 14.
    Hiller L, Radley S, Mann CH et al (2002) Development and validation of a questionnaire for the assessment of bowel and urinary tract symptoms in women. Br J Obstet Gynaecol 109:413–423CrossRefGoogle Scholar
  15. 15.
    Agachan F, Chen T, Pfeifer J et al (1996) A constipation scoring system to simplify evaluation and management of constipated patients. Dis Colon Rectum 39:681–685PubMedCrossRefGoogle Scholar
  16. 16.
    Beer-Gabel M, Teshler M, Barzilai N et al (2002) Dynamic transpeineal ultrasound in the diagnosis of pelvic floor disorders: pilot study. Dis Colon Rectum 45:239–245PubMedCrossRefGoogle Scholar
  17. 17.
    Beer-Gabel M, Teshler M, Schechtman E et al (2004) Dynamic transperineal ultrasound vs. defecography in patients with evacuatory difficulty: a pilot study. Int J Colorectal Dis 19:60–67PubMedCrossRefGoogle Scholar
  18. 18.
    Abrams P, Cardozo L, Fall M et al (2003) The standardization of terminology in lower urinary tract function: report from the standardization sub-committee of the International Continence Society. Urology 61:37–49PubMedCrossRefGoogle Scholar
  19. 19.
    Gulur DM, Mevcha AM, Drake MJ (2011) Nocturia as a manifestation of systemic disease. BJU Int 107(5):702–713PubMedCrossRefGoogle Scholar
  20. 20.
    Bump RC, Mattiasson A, Bø K et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17PubMedCrossRefGoogle Scholar
  21. 21.
    Shorvon PJ, McHugh S, Diamant NE et al (1989) Defecography in normal volunteers: results and implications. Gut 30:1737–1749PubMedCrossRefGoogle Scholar
  22. 22.
    Shorvon PJ, Marshall MM (2005) Evacuation proctography. Springer Verlag, LondonGoogle Scholar
  23. 23.
    Ewings P, Spencer S, Marsh H et al (2005) Obstetric risk factors for urinary incontinence and preventative pelvic floor excersice: cohort study and nested randomized controlled trail. J Obstet Gynacol 25:558–564CrossRefGoogle Scholar
  24. 24.
    Spence-Jones C, Kamm MA, Henry MM et al (1994) Bowel dysfunction: a pathogenic factor in uterovesical prolapse and urinary stress incontinence. Br J Obstet Gynaecol 101:147–152PubMedCrossRefGoogle Scholar
  25. 25.
    Buntzen S, Nordgren S, Delbro D et al (1995) Anal and rectal motility responds to distension of the urinary bladder in man. Int J Colorectal Dis 10:148–151PubMedCrossRefGoogle Scholar
  26. 26.
    de Paepe H, Renson C, Van Laecke E et al (2000) Pelvic floor therapy and toilet training in young children with dysfunctional voiding and obstipation. BJU Int 85:889–893PubMedCrossRefGoogle Scholar
  27. 27.
    Myers DL, Lasala CA, Hogan JW et al (1998) The effect of posterior wall support defects on urodynamic indices in stress urinary incontinence. Obstet Gynecol 91:710PubMedCrossRefGoogle Scholar
  28. 28.
    Dietz HP, Lekskulchai O (2007) Ultrasound assessment of pelvic organ prolapse: the relationship between prolapse severity and symptoms. Ultrasound Obstet Gynecol 29:688–691PubMedCrossRefGoogle Scholar
  29. 29.
    Marinkovic SP, Stanton SL (2004) Incontinence and voiding difficulties associated with prolapse. J Urol 171:1021–1028PubMedCrossRefGoogle Scholar
  30. 30.
    Gou YJ, Ho CH, Chen SC et al (2010) Lower urinary tract symptoms in women with irritable bowel syndrome. Int J Urol 17:175–181CrossRefGoogle Scholar

Copyright information

© The International Urogynecological Association 2012

Authors and Affiliations

  1. 1.Pelvic Floor Service, Department of GastroenterologySheba Medical CenterRamat GanIsrael

Personalised recommendations