Chris Shaw

Prevalence of faecal incontinence in adults aged 40 years or more living in the community.

Background: Prevalence studies of faecal incontinence in the general population are rare and the impact of faecal incontinence on quality of life has not been previously addressed. Aims: To establish the prevalence of faecal incontinence in adults in terms of frequency of leakage, degree of soiling, and level of impact on quality of life. Methods: In a cross sectional postal survey, 15 904 adults aged 40 years or more (excluding residents of nursing and residential homes) were selected randomly by household from the Leicestershire Health Authority patient register. Participants were asked to complete a confidential health questionnaire. Major faecal incontinence was defined as soiling of underwear or worse with a frequency of several times a month or more. Respondents were also asked if bowel symptoms had an impact on their quality of life. Results: From a total sample of 10 116 respondents, 1.4% reported major faecal incontinence and 0.7% major faecal incontinence with bowel symptoms that had an impact on quality of life. Major faecal incontinence was significantly associated with a lot of impact on quality of life (odds ratio 12.4, 95% confidence interval 7.5–20.6). Incontinence was more prevalent and more severe in older people but there was no significant difference between men and women. Conclusions: This study has confirmed that faecal incontinence is a fairly common symptom, particularly in older people. Faecal incontinence in men has received little attention in the past and the results from this study indicate that it is as much of a problem in men as it is in women while the level of unmet need in this group is high. Estimates of need for health care for this symptom should be multidimensional and assess both the severity of symptoms and the impact it has on quality of life.

A Systematic Review of the Literature on the Prevalence of Sexual Impairment in Women with Urinary Incontinence and the Prevalence of Urinary Leakage during Sexual Activity

OBJECTIVE To provide a synthesis of the literature concerning the impact of urinary incontinence on sexual lives of women and the prevalence of urinary incontinence during sexual activity. METHODS Medline and PsycInfo were searched for all primary epidemiological articles reporting the prevalence of sexual incontinence or the impact of urinary incontinence on sexual function in women. Only papers written in English since 1980 and prior to December 2001 were included. RESULTS Two studies had assessed the prevalence of sexual incontinence in randomly selected community samples and reported population prevalences of 2%. Reporting in clinical samples were varied with prevalences ranging from 10 to 56%. Studies of impairment in sexual function were more varied and methodologically heterogeneous with reported prevalences of 0.6-64%. CONCLUSIONS Further research is needed using standard definitions and measures of sexual incontinence and sexual impairment in order to establish reliable prevalence estimates.

Prevalence and Impact of Urinary Symptoms Among Community-Dwelling Stroke Survivors

BACKGROUND AND PURPOSE To establish prevalence of urinary symptoms among community-dwelling stroke survivors and how these symptoms affected lives of these survivors compared with a nonstroke population. METHODS The present study was a community-based postal survey in Leicestershire community, UK (that excluded institutional settings), that was designed to track stroke, urinary, and bowel symptoms and the effect of such symptoms on relationships, social life, daily activities, and overall quality of life. Subjects included 14 600 people who were living in the community and </=40 years of age, randomly selected from the Leicestershire Health Authority Register. RESULTS A 70% response rate was achieved with the return of 10 226 questionnaires. Prevalence of reported stroke was 4% (n=423). Prevalence of urinary symptoms was 34% (n=3197). Overall, stroke survivors had a higher prevalence of symptoms than the nonstroke population (64% to 32%, respectively). These symptoms were reported to have more of an effect on the lives of the stroke survivors compared with the nonstroke population even when adjusted for age and sex differences. This reported impact was not related to the stroke per se but to the severity of the urinary symptoms. CONCLUSIONS These data show a high prevalence of urinary symptoms among community-dwelling stroke survivors. These symptoms were reported to have considerable impact on the lives of stroke survivors, which needs to be taken into account in future research and clinical practice.

The association of diet and other lifestyle factors with the onset of overactive bladder: a longitudinal study in men

OBJECTIVE To investigate associations between diet and non-dietary lifestyle factors and the onset of overactive bladder (OAB) in men. SUBJECTS Random sample of community-dwelling men aged 40 years plus. DESIGN AND METHODS Baseline data on urinary symptoms and diet were collected from 5454 men using a postal questionnaire and a food-frequency questionnaire. Follow-up data on urinary symptoms were collected from 4887 men in a postal survey one year later. Logistic regression analysis was used to investigate diet and lifestyle factors associated with onset of OAB in the men without OAB at baseline. RESULTS There was a highly significant negative association between beer intake at baseline and subsequent OAB onset (P=0.001), with reduced risk at all levels of intake compared with those who seldom/never drank beer. Adjustment for total alcohol intake (g ethanol day(-1)) reduced the significance of the association (P=0.02). None of the food groups studied was associated with OAB onset, with the possible exception of potatoes (P=0.05), which showed an increased risk of onset at the highest level of consumption. Physical activity, smoking and obesity were not significantly associated. CONCLUSIONS While most diet and lifestyle factors were not associated with OAB onset, the evidence from this prospective longitudinal study suggests that beer may have a protective role in the development of OAB. This could be due to a non-alcoholic ingredient as well as the alcohol content.

Isolated urinary, fecal, and double incontinence: prevalence and degree of soiling in stroke survivors

OBJECTIVES: To investigate the prevalence of isolated urinary and fecal incontinence and double incontinence in community‐living stroke survivors and to assess the degree of soiling.