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Does parity impact obstructed defecation in women with normal anorectal anatomy?

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Abstract

Introduction and hypothesis

Obstructed defecation (OD) is often associated with trauma to pelvic connective tissue and nerves sustained during pregnancy and childbirth. Although there are multiple potential etiologies of defecatory dysfunction, the pathophysiology of this symptom complex is not well understood. The purpose of this study is to determine the role of parity in the development of obstructed defecatory symptoms in women with normal anorectal anatomy in a search for evidence of a presumptive neuropathic effect of pregnancy and childbirth.

Methods

This study retrospectively evaluated the records of 754 women presenting at a tertiary urogynecology unit for pelvic floor dysfunction with no anatomical abnormalities of the anorectum on imaging. They were stratified according to parity. The authors determined the prevalence of obstructed defecation symptoms in these groups. Chi-squared test was performed for statistical analysis.

Results

Median age was 51 (range 16–88) years, and median vaginal parity was 2 (0–8); 399 (53%) women reported symptoms of OD. When anatomical abnormalities of the anorectum were excluded, parity did not seem to have a major effect on the prevalence of symptoms of OD.

Conclusions

In this cohort, parity is unlikely to be a cause of OD in women with normal anorectal anatomy.

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Author information

Authors and Affiliations

  1. Sydney Medical School Nepean, University of Sydney, Sydney, Australia

    Nishamini Subramaniam, Francisca Andrea Solar Altamirano, Talia Friedman Barhum, Bernadette Brown & Hans Peter Dietz

  2. Northern Beaches Hospital, Frenchs Forest, Sydney, Australia

    Nishamini Subramaniam

  3. Hospital Clínico San Borja Arriaran, Universidad de Chile, Santiago, Chile

    Francisca Andrea Solar Altamirano

  4. Chaim Sheba Medical Center, Tel Hashomer, Tel Aviv University, Tel Aviv-Yafo, Israel

    Talia Friedman Barhum

  5. Pindara Private Hospital, Gold Coast, Australia

    Bernadette Brown

Authors
  1. Nishamini Subramaniam
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  2. Francisca Andrea Solar Altamirano
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  3. Talia Friedman Barhum
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  4. Bernadette Brown
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  5. Hans Peter Dietz
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Contributions

N Subramaniam: Project development, data acquisition, analysis and interpretation, manuscript writing and critical revision for intellectual content and final approval of the version to be published.

FA Solar Altamirano: Data acquisition, analysis and interpretation, manuscript editing and final approval of the version to be published.

T Friedman Barhum: Data acquisition, analysis and interpretation, manuscript editing and final approval of the version to be published.

B Brown: Data acquisition, analysis and interpretation, manuscript editing and final approval of the version to be published.

HP Dietz: Project conception, design and development, data management, analysis and interpretation, manuscript editing and critical revision for intellectual content and final approval of the version to be published.

Corresponding author

Correspondence to Nishamini Subramaniam.

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Conflicts of interest

HP Dietz has received unrestricted educational grants from GE Medical. All other authors have no conflict of interest to declare.

Conference presentations

This work was a podium presentation at the IUGA 42nd Annual Meeting, Vancouver, Canada, from June 20 to 24, 2017.

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Subramaniam, N., Altamirano, F.A.S., Barhum, T.F. et al. Does parity impact obstructed defecation in women with normal anorectal anatomy?. Int Urogynecol J 33, 3423–3428 (2022). https://doi.org/10.1007/s00192-022-05226-1

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  • DOI: https://doi.org/10.1007/s00192-022-05226-1

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